Healthcare Provider Details

I. General information

NPI: 1699414573
Provider Name (Legal Business Name): CASEY SCURLOCK MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 05/31/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 N HIGH ST
NEW ALBANY OH
43054-7099
US

IV. Provider business mailing address

55 N HIGH ST
NEW ALBANY OH
43054-7099
US

V. Phone/Fax

Practice location:
  • Phone: 614-627-1878
  • Fax:
Mailing address:
  • Phone: 614-627-1878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN.354090
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: