Healthcare Provider Details

I. General information

NPI: 1942761853
Provider Name (Legal Business Name): ELIZABETH HOTT NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17978 SR 55
BAKER WV
26801
US

IV. Provider business mailing address

PO BOX 97
BAKER WV
26801-0097
US

V. Phone/Fax

Practice location:
  • Phone: 304-897-5915
  • Fax: 304-897-6216
Mailing address:
  • Phone: 304-897-5915
  • Fax: 304-897-6216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number102476
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: