Healthcare Provider Details

I. General information

NPI: 1093653214
Provider Name (Legal Business Name): HOLLY SCOTT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 W MAIN ST
DECATURVILLE TN
38329-8078
US

IV. Provider business mailing address

364 TENNESSEE AVE S
PARSONS TN
38363-2524
US

V. Phone/Fax

Practice location:
  • Phone: 731-852-2761
  • Fax:
Mailing address:
  • Phone: 731-798-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number41246
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: