Healthcare Provider Details

I. General information

NPI: 1275993578
Provider Name (Legal Business Name): DIANA CHRISTINE SCOTT CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2016
Last Update Date: 10/15/2023
Certification Date: 10/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ELIZABETH PL # 1010A
DAYTON OH
45417-3445
US

IV. Provider business mailing address

302 WHITEHALL DR
YELLOW SPRINGS OH
45387-1938
US

V. Phone/Fax

Practice location:
  • Phone: 937-222-3544
  • Fax:
Mailing address:
  • Phone: 937-901-8892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number18442
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number18442
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: