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General NPI Number Information
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NPI Number | 1164749263
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Entity Type | Individual
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Provider Name | LITA A SCOTT FNP
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Gender | Female
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Dates
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Enumeration Date | 04/28/2010
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Last Update Date | 09/28/2015
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Provider Practice Location Address
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Address Line | 2920 N 4TH ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-1816
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Country | US
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Telephone | 928-213-6100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3630
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City | FLAGSTAFF
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State | AZ
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Zip | 86003-3630
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Country | US
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Telephone | 928-213-6110
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP3632
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License Number State | AZ
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