Healthcare Provider Details

I. General information

NPI: 1750285730
Provider Name (Legal Business Name): CHRISTINE MARIE SCOTT RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 N 92ND STREET
MILWAUKEE WI
53225
US

IV. Provider business mailing address

4619 KENRICH DR
CALEDONIA WI
53402-5340
US

V. Phone/Fax

Practice location:
  • Phone: 414-616-5620
  • Fax: 414-616-5615
Mailing address:
  • Phone: 414-616-5620
  • Fax: 414-616-5615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number197032-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: