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General NPI Number Information
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NPI Number | 1033341136
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Entity Type | Individual
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Provider Name | DEBORAH JEAN MOTL
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Gender | Female
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Dates
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Enumeration Date | 08/23/2009
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Last Update Date | 08/23/2009
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Provider Practice Location Address
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Address Line | 2000 BOISE AVE
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City | LOVELAND
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State | CO
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Zip | 80538-5006
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Country | US
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Telephone | 916-295-4519
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Fax |
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Provider Business Mailing Address
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Address Line | 7103 RANGER DR
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City | FORT COLLINS
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State | CO
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Zip | 80526-9617
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Country | US
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Telephone | 916-295-4519
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 50526
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License Number State | CO
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