Healthcare Provider Details

I. General information

NPI: 1114837341
Provider Name (Legal Business Name): KRISTIN SCOTT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 NICHOLS ST
WELLSBORO PA
16901-1122
US

IV. Provider business mailing address

601 NORTH RD
MIDDLEBURY CENTER PA
16935-9445
US

V. Phone/Fax

Practice location:
  • Phone: 607-382-7597
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN690916
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: