Healthcare Provider Details

I. General information

NPI: 1053089714
Provider Name (Legal Business Name): ALEXUS D. SCOTT M.S. WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2021
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2048 CHARLIE HALL BLVD.
CHARLESTON SC
29414-5830
US

IV. Provider business mailing address

2048 CHARLIE HALL BLVD.
CHARLESTON SC
29414-5830
US

V. Phone/Fax

Practice location:
  • Phone: 843-804-6010
  • Fax: 843-804-6011
Mailing address:
  • Phone: 843-804-6010
  • Fax: 843-804-6011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number104454191
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: