Provider Demographics
NPI:1821988338
Name:MOTTINGER, KELLY (RN)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:MOTTINGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 N 610 W
Mailing Address - Street 2:
Mailing Address - City:VEYO
Mailing Address - State:UT
Mailing Address - Zip Code:84782-4153
Mailing Address - Country:US
Mailing Address - Phone:435-817-0117
Mailing Address - Fax:
Practice Address - Street 1:459 N 610 W
Practice Address - Street 2:
Practice Address - City:VEYO
Practice Address - State:UT
Practice Address - Zip Code:84782-4153
Practice Address - Country:US
Practice Address - Phone:435-817-0117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10270098-3102163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management