Individual
ALAN W MOTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP -C
Contact information
Practice address
1110 E ROUTE 66, FLAGSTAFF, AZ 86001-4771
(928) 773-9695
(928) 772-0208
Mailing address
1110 E ROUTE 66, FLAGSTAFF, AZ 86001-4771
(928) 773-9695
(928) 772-0208
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN076694
AZ
363LF0000X
Family Nurse Practitioner
AZ AP 2229
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00640
—
AZ
Enumeration date
03/08/2006
Last updated
12/15/2011
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