Healthcare Provider Details

I. General information

NPI: 1881024818
Provider Name (Legal Business Name): MARY CATHERINE SCOTT APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY CATHERINE SIMS

II. Dates (important events)

Enumeration Date: 11/12/2013
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7936 US HIGHWAY 277
ELGIN OK
73538-2144
US

IV. Provider business mailing address

PO BOX 48089
ATHENS GA
30604-8089
US

V. Phone/Fax

Practice location:
  • Phone: 580-493-6900
  • Fax: 580-492-6902
Mailing address:
  • Phone: 706-389-3740
  • Fax: 706-389-3951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN281523
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR0097211
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: