Individual
RENEE MOTTOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP-FNP-C
Contact information
Practice address
1621 N 3RD ST STE 850, COEUR D ALENE, ID 83814-3326
(208) 992-4184
Mailing address
1113 E HORSEHAVEN AVE, POST FALLS, ID 83854-6014
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
69217
ID
363LF0000X
Family Nurse Practitioner
Primary
6961760
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6961760
DEPARTMENT OF OCCUPATIONAL AND PROFESSIONAL LICENSES
ID
Enumeration date
07/09/2024
Last updated
07/17/2024
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