MEDICARE: ROBIN ANNETTE SWANTACK SCOTT NP

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	363LW0102X	Women's Health Nurse Practitioner	28072771A	IN
2	363LW0102X	Women's Health Nurse Practitioner	71004103A	IN

General Provider Information

NPI Number	:	1023454972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN ANNETTE SWANTACK SCOTT NP

Provider Business Mailing Address
First Line	:	10610 N PENNSYLVANIA ST
Second Line	:	SUIITE 101
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46280-2004
Country	:	US
Telephone Number	:	317-814-4110
Fax Number	:

Provider Business Practice Location Address
First Line	:	10610 N PENNSYLVANIA ST
Second Line	:	SUIITE 101
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46280-2004
Country	:	US
Telephone Number	:	317-814-4110
Fax Number	:

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

Provider Enumeration Date	:	05/20/2013
Last Update Date	:	05/20/2013

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