Healthcare Provider Details

I. General information

NPI: 1104853118
Provider Name (Legal Business Name): DEBORAH SCOTT MSN, RN, CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 01/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 N 1ST ST
DENNISON OH
44621-1003
US

IV. Provider business mailing address

819 N FIRST ST
DENNISON OH
44621
US

V. Phone/Fax

Practice location:
  • Phone: 740-922-2800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN148491
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.04382-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: