Healthcare Provider Details

I. General information

NPI: 1639152853
Provider Name (Legal Business Name): KAREN M.R. SCOTT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2360 STOCKTON BLVD SUITE 1100
SACRAMENTO CA
95817-2228
US

IV. Provider business mailing address

4031 TILDEN DR
ROSEVILLE CA
95661-7949
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-3461
  • Fax: 916-734-3591
Mailing address:
  • Phone: 916-783-7430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN395895
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: