Healthcare Provider Details

I. General information

NPI: 1366381501
Provider Name (Legal Business Name): TIMALETHIA ALEDRIANNE SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5920 DIXIE LN
MOBILE AL
36693-3007
US

IV. Provider business mailing address

5920 DIXIE LN
MOBILE AL
36693-3007
US

V. Phone/Fax

Practice location:
  • Phone: 251-422-1429
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-168799
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: