Provider Demographics
NPI:1255633103
Name:MOTT, CHRISTINE LYNN (CFNP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LYNN
Last Name:MOTT
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 MICHAEL DEVELOPEMENT RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-8637
Mailing Address - Country:US
Mailing Address - Phone:304-598-4000
Mailing Address - Fax:304-598-4910
Practice Address - Street 1:123 MICHAEL DEVELOPEMENT RD
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-8637
Practice Address - Country:US
Practice Address - Phone:304-598-4000
Practice Address - Fax:304-598-4910
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2004000911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily