Healthcare Provider Details

I. General information

NPI: 1073994224
Provider Name (Legal Business Name): BILLIE ANN SCOTT NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2015
Last Update Date: 12/19/2021
Certification Date: 12/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 E BATTLEFIELD ST
SPRINGFIELD MO
65804-3981
US

IV. Provider business mailing address

3817 S SPRINGFIELD AVE
BOLIVAR MO
65613-9129
US

V. Phone/Fax

Practice location:
  • Phone: 417-888-0298
  • Fax:
Mailing address:
  • Phone: 417-730-3508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2015019812
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: