Healthcare Provider Details

I. General information

NPI: 1790339828
Provider Name (Legal Business Name): KRISTEN LEIGH MOTT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN LEIGH BITTER

II. Dates (important events)

Enumeration Date: 07/26/2019
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3426 MOUNDS RD
ANDERSON IN
46017-1873
US

IV. Provider business mailing address

16672 SALIMONIA LN
WESTFIELD IN
46074-8107
US

V. Phone/Fax

Practice location:
  • Phone: 866-808-6005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10004456A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: