Healthcare Provider Details

I. General information

NPI: 1013049691
Provider Name (Legal Business Name): SUSAN RENEE SCOTT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2007
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2941 SIERRA CT SW
IOWA CITY IA
52240-8503
US

IV. Provider business mailing address

2941 SIERRA CT SW
IOWA CITY IA
52240-8503
US

V. Phone/Fax

Practice location:
  • Phone: 319-337-7642
  • Fax: 319-339-1449
Mailing address:
  • Phone: 319-337-7642
  • Fax: 319-339-1449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA095863
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: