Healthcare Provider Details

I. General information

NPI: 1558088252
Provider Name (Legal Business Name): DANIELLE LYNN SCOTT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41930 N VENTURE DR
PHOENIX AZ
85086-3857
US

IV. Provider business mailing address

8715 W GROVERS AVE
PEORIA AZ
85382-3067
US

V. Phone/Fax

Practice location:
  • Phone: 623-551-0442
  • Fax:
Mailing address:
  • Phone: 661-208-1662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number240020
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: