Healthcare Provider Details

I. General information

NPI: 1245165943
Provider Name (Legal Business Name): EMMA SCOTT PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W KINGSTON AVE APT 319
CHARLOTTE NC
28203-6443
US

IV. Provider business mailing address

120 W KINGSTON AVE APT 319
CHARLOTTE NC
28203-6443
US

V. Phone/Fax

Practice location:
  • Phone: 610-425-2197
  • Fax:
Mailing address:
  • Phone: 610-425-2197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5024893
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: