Healthcare Provider Details

I. General information

NPI: 1720108855
Provider Name (Legal Business Name): PATRICIA DARLENE SCOTT-MARSH R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 NE D ST SUITE B
STIGLER OK
74462-2815
US

IV. Provider business mailing address

RR 2 BOX 5430
PORUM OK
74455-9511
US

V. Phone/Fax

Practice location:
  • Phone: 918-967-8491
  • Fax:
Mailing address:
  • Phone: 918-484-5472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR 0027344
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: