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NPI Code Detail

MEDICARE: SUSAN C SCOUTEN APRN-BC, FNP

MEDICARE: SUSAN C SCOUTEN APRN-BC, FNP
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
1363LF0000XFamily Nurse PractitionerAPRN 213SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00906566OTHERSCRAILROAD MEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912988411
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN C SCOUTEN APRN-BC, FNP
Provider Business Mailing Address
First Line : 13 TETON RD
Second Line :
City : SUMTER
State : SC
Zip : 29154-4659
Country : US
Telephone Number : 803-469-9819
Fax Number :
Provider Business Practice Location Address
First Line : 545 SUMTER HWY
Second Line :
City : BISHOPVILLE
State : SC
Zip : 29010-7601
Country : US
Telephone Number : 803-484-5317
Fax Number : 803-484-4533
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2005
Last Update Date : 04/28/2011

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