Provider Demographics
NPI:1699529479
Name:MOTT, ASHLYN
Entity type:Individual
Prefix:
First Name:ASHLYN
Middle Name:
Last Name:MOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 COUNTY ROAD 685
Mailing Address - Street 2:
Mailing Address - City:RANBURNE
Mailing Address - State:AL
Mailing Address - Zip Code:36273-3581
Mailing Address - Country:US
Mailing Address - Phone:256-201-3357
Mailing Address - Fax:
Practice Address - Street 1:357 COUNTY ROAD 685
Practice Address - Street 2:
Practice Address - City:RANBURNE
Practice Address - State:AL
Practice Address - Zip Code:36273-3581
Practice Address - Country:US
Practice Address - Phone:256-201-3357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030061411376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide