Healthcare Provider Details

I. General information

NPI: 1518253368
Provider Name (Legal Business Name): KAREN SUE SCOTT APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 NAVAJO BLVD
HOLBROOK AZ
86025-1822
US

IV. Provider business mailing address

740 S LIMESTONE ST KENTUCKY CLINIC E207
LEXINGTON KY
40536-2774
US

V. Phone/Fax

Practice location:
  • Phone: 928-524-2851
  • Fax:
Mailing address:
  • Phone: 859-323-5956
  • Fax: 859-323-1080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3006962
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: