Individual
ELLEN M OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
3111 GUNDERSEN DRIVE, ONALASKA, WI 54650
(608) 796-8630
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1141
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43865500
—
WI
Enumeration date
06/13/2005
Last updated
06/06/2018
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