Healthcare Provider Details

I. General information

NPI: 1891626537
Provider Name (Legal Business Name): MAKENZIE FAITH SCOTT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

879 HOSPITAL RD STE 3200
INDIANA PA
15701-3629
US

IV. Provider business mailing address

1631 ROUTE 56 HWY E
HOMER CITY PA
15748-6534
US

V. Phone/Fax

Practice location:
  • Phone: 724-464-2771
  • Fax: 724-464-0274
Mailing address:
  • Phone: 724-549-2352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA067783
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: