Mottinger, Keven R

Mottinger, Keven R is an individual health care provider with primary practice located at 3400 Market Ln , Kenosha WI 53144-3430. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mottinger, Keven R can be contacted via phone (262) 551-4600.

Contact Information

Primary practice address
3400 Market Ln Kenosha WI 53144-3430
Phone: (262) 551-4600
Fax: (262) 551-4630
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1868 Wisconsin

Profile Details

NPI number 1154377091
LBN Legal business name Mottinger, Keven R
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2006
Last updated Aug 31st, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154377091 NPPES
Other 12006222 CAQH

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