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NPI Code Detail

MEDICARE: LEAH MOTT

MEDICARE: LEAH MOTT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner1117733WI

General Provider Information

NPI Number : 1346813169
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH MOTT
Provider Business Mailing Address
First Line : 5215 N IRONWOOD RD STE 202
Second Line :
City : GLENDALE
State : WI
Zip : 53217-4908
Country : US
Telephone Number : 414-240-9378
Fax Number :
Provider Business Practice Location Address
First Line : 5215 N IRONWOOD RD STE 202
Second Line :
City : GLENDALE
State : WI
Zip : 53217-4908
Country : US
Telephone Number : 414-240-9378
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2021
Last Update Date : 03/02/2026

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Directions to “ LEAH MOTT ” Practice Location

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