Healthcare Provider Details

I. General information

NPI: 1538732722
Provider Name (Legal Business Name): SCOTT DRINNON RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2021
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 E WASHINGTON BLVD STE 100
CRESCENT CITY CA
95531-8161
US

IV. Provider business mailing address

1275 8TH ST
ARCATA CA
95521-5770
US

V. Phone/Fax

Practice location:
  • Phone: 707-465-4636
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4709730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: