Healthcare Provider Details

I. General information

NPI: 1578498077
Provider Name (Legal Business Name): ALEXIS M SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 JOSEPH SIEWICK DR # FR
FAIRFAX VA
22033-1709
US

IV. Provider business mailing address

19237 GOLDEN MEADOW DR
GERMANTOWN MD
20876-1759
US

V. Phone/Fax

Practice location:
  • Phone: 703-391-3600
  • Fax:
Mailing address:
  • Phone: 240-498-5059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberR252484
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: