Healthcare Provider Details

I. General information

NPI: 1083992341
Provider Name (Legal Business Name): ANN M. SCOTT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 12/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 N MAIN ST
BRADY NE
69123-2749
US

IV. Provider business mailing address

918 20TH ST 114 N. MAIN
GOTHENBURG NE
69138-1237
US

V. Phone/Fax

Practice location:
  • Phone: 308-584-3770
  • Fax: 308-584-3772
Mailing address:
  • Phone: 308-537-4066
  • Fax: 308-537-7310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number111251
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: