Healthcare Provider Details

I. General information

NPI: 1164643649
Provider Name (Legal Business Name): SUSAN KOSTER SCOTT RNC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 CUMBERLAND BND
NASHVILLE TN
37228
US

IV. Provider business mailing address

275 CUMBERLAND BND
NASHVILLE TN
37228
US

V. Phone/Fax

Practice location:
  • Phone: 615-230-9663
  • Fax: 615-230-8982
Mailing address:
  • Phone: 615-230-9663
  • Fax: 615-230-8982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN0000142756
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: