Healthcare Provider Details

I. General information

NPI: 1073992277
Provider Name (Legal Business Name): MRS. TERRA JASMINE SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS TERRA JASMINE MONTOYA

II. Dates (important events)

Enumeration Date: 05/21/2015
Last Update Date: 05/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 N EMERSON ST
DENVER CO
80218-1412
US

IV. Provider business mailing address

1610 N EMERSON ST
DENVER CO
80218-1412
US

V. Phone/Fax

Practice location:
  • Phone: 303-504-6500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: