Provider Demographics
NPI:1932735149
Name:MOTEE, BHANMATTIE ANUPA (RN, BSN, MSN)
Entity Type:Individual
Prefix:MS
First Name:BHANMATTIE
Middle Name:ANUPA
Last Name:MOTEE
Suffix:
Gender:F
Credentials:RN, BSN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55364
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-5364
Mailing Address - Country:US
Mailing Address - Phone:404-245-4735
Mailing Address - Fax:
Practice Address - Street 1:1712 CASTLE CT
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30296-2946
Practice Address - Country:US
Practice Address - Phone:404-245-4735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN133200163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management