Healthcare Provider Details

I. General information

NPI: 1144125378
Provider Name (Legal Business Name): SAMANTHA GALLUES SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10315 PROFESSIONAL CIR
RENO NV
89521-4802
US

IV. Provider business mailing address

230 MEADOW BROOK DR
RENO NV
89519-2174
US

V. Phone/Fax

Practice location:
  • Phone: 800-336-0123
  • Fax:
Mailing address:
  • Phone: 775-982-7222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number822932
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: