Provider Demographics
NPI:1861475014
Name:MOTTS, LINDA Z (APRN/PMH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:Z
Last Name:MOTTS
Suffix:
Gender:F
Credentials:APRN/PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 WADSWORTH WAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2413
Mailing Address - Country:US
Mailing Address - Phone:410-375-3854
Mailing Address - Fax:410-882-1079
Practice Address - Street 1:7001 JOHNNYCAKE RD STE 107
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244
Practice Address - Country:US
Practice Address - Phone:410-375-3854
Practice Address - Fax:410-933-9066
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR060028163WP0808X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD114087OtherVALUEOPTIONS
MD231279OtherMEDICARE PTAN
MD229101100Medicaid