Individual
BEVERLY M MOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 SEMINARY ST, KENANSVILLE, NC 28349-8978
(910) 296-2130
Mailing address
PO BOX 948, KENANSVILLE, NC 28349-0948
(910) 214-1779
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5013422
NC
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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