Healthcare Provider Details

I. General information

NPI: 1689831786
Provider Name (Legal Business Name): VIVIAN HON WEI SCANLON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIVIAN HON WEI YUEN

II. Dates (important events)

Enumeration Date: 05/18/2008
Last Update Date: 02/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 MEDICAL PKWY SUITE 635
ANNAPOLIS MD
21401-3046
US

IV. Provider business mailing address

PO BOX 12622
BELFAST ME
04915-4017
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-1133
  • Fax: 410-266-1639
Mailing address:
  • Phone: 410-224-1133
  • Fax: 410-266-1639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberR189122
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR189122
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: