Healthcare Provider Details

I. General information

NPI: 1306788450
Provider Name (Legal Business Name): DYANDRIA SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 QUADRANGLE DR
CHAPEL HILL NC
27517-8279
US

IV. Provider business mailing address

68 FARMINGTON LN
HENDERSON NC
27537-5705
US

V. Phone/Fax

Practice location:
  • Phone: 888-849-7379
  • Fax:
Mailing address:
  • Phone: 516-424-5466
  • Fax: 516-424-5466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5024290
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: