Healthcare Provider Details

I. General information

NPI: 1588201552
Provider Name (Legal Business Name): LAUREN PAIGE SCOTT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 MANCHESTER RD # 70
SAINT LOUIS MO
63131-1703
US

IV. Provider business mailing address

13100 MANCHESTER RD # 70
SAINT LOUIS MO
63131-1703
US

V. Phone/Fax

Practice location:
  • Phone: 314-492-2323
  • Fax:
Mailing address:
  • Phone: 314-492-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2019044822
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: