Healthcare Provider Details

I. General information

NPI: 1689426439
Provider Name (Legal Business Name): ERICA SCOTT FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7338 TANNOIA DR
HAZELWOOD MO
63042-1344
US

IV. Provider business mailing address

7338 TANNOIA DR
HAZELWOOD MO
63042-1344
US

V. Phone/Fax

Practice location:
  • Phone: 314-363-6718
  • Fax:
Mailing address:
  • Phone: 314-363-6718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026015927
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2007005545
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: