Healthcare Provider Details

I. General information

NPI: 1568293587
Provider Name (Legal Business Name): ALEXIS ERICA SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 08/12/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4494 PALMER RD N
BETHESDA, MD 20814 MD
20814
US

IV. Provider business mailing address

4923 VISTA GREEN LN
LANHAM MD
20706-2893
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN500018317
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR234587
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR234587
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: