Healthcare Provider Details

I. General information

NPI: 1700260619
Provider Name (Legal Business Name): NIKKI JEAN SCOTT PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2015
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 OTTO RD
CONWAY AR
72032-9793
US

IV. Provider business mailing address

564 OTTO RD
CONWAY AR
72032-9793
US

V. Phone/Fax

Practice location:
  • Phone: 479-774-3915
  • Fax:
Mailing address:
  • Phone: 479-774-3915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD13274
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPD13274
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: