MEDICARE: MRS. SUSAN RENEE SCOTT ARNP

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
1	363LF0000X	Family Nurse Practitioner	A095863	IA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00474252	OTHER	IA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013049691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN RENEE SCOTT ARNP

Provider Business Mailing Address
First Line	:	2941 SIERRA CT SW
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-8503
Country	:	US
Telephone Number	:	319-337-7642
Fax Number	:	319-339-1449

Provider Business Practice Location Address
First Line	:	2941 SIERRA CT SW
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-8503
Country	:	US
Telephone Number	:	319-337-7642
Fax Number	:	319-339-1449

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2007
Last Update Date	:	10/21/2008

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