Provider Demographics
NPI:1669814950
Name:HOTT, CHAD TAYLOR (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:TAYLOR
Last Name:HOTT
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 S MARSHAM ST
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-1725
Mailing Address - Country:US
Mailing Address - Phone:304-359-2245
Mailing Address - Fax:304-359-2259
Practice Address - Street 1:1 S MARSHAM ST
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-1725
Practice Address - Country:US
Practice Address - Phone:304-359-2245
Practice Address - Fax:304-359-2259
Is Sole Proprietor?:No
Enumeration Date:2013-07-27
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN57763-FNP-BC363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1669814950Medicare UPIN