Healthcare Provider Details

I. General information

NPI: 1790615524
Provider Name (Legal Business Name): BIANCA CHERELLE SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5338 E 35TH PL
TULSA OK
74135-5225
US

IV. Provider business mailing address

5338 E 35TH PL
TULSA OK
74135-5225
US

V. Phone/Fax

Practice location:
  • Phone: 918-933-9573
  • Fax:
Mailing address:
  • Phone: 918-933-9573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: