Healthcare Provider Details

I. General information

NPI: 1104487966
Provider Name (Legal Business Name): BREANNA JO SCOTT MARKER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BREANNA JO SCOTT OD

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 STATE ST
GARNER IA
50438-1108
US

IV. Provider business mailing address

45 STATE ST
GARNER IA
50438-1108
US

V. Phone/Fax

Practice location:
  • Phone: 641-923-3737
  • Fax: 641-923-3254
Mailing address:
  • Phone: 641-923-3737
  • Fax: 641-923-3254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number096551
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number096551
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: