Healthcare Provider Details

I. General information

NPI: 1184130684
Provider Name (Legal Business Name): ANNA M MOTOLA DNP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA FROELICH

II. Dates (important events)

Enumeration Date: 12/19/2017
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13395 N MARANA MAIN ST
MARANA AZ
85653-7008
US

IV. Provider business mailing address

PO BOX 188
MARANA AZ
85653-0188
US

V. Phone/Fax

Practice location:
  • Phone: 520-682-4111
  • Fax: 520-682-3817
Mailing address:
  • Phone: 520-682-4111
  • Fax: 520-682-3817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP10783
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP10783
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11041476
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: