Healthcare Provider Details

I. General information

NPI: 1710056494
Provider Name (Legal Business Name): CAROL FOSTER SCOTT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROL LYNN SCOTT FNP

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 STATE FARM RD BLUE RIDGE ENT SUITE 101
BOONE NC
28607
US

IV. Provider business mailing address

186 BAMBI LANE
WEST JEFFERSON NC
28694
US

V. Phone/Fax

Practice location:
  • Phone: 828-264-4545
  • Fax: 828-264-4544
Mailing address:
  • Phone: 336-877-1502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200336
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: