NPI Code Detail JSON Logo

1174169486 NPI number — CRYSTAL SCOTT MS, FNP

NPI Number: 1174169486
Health Care Provider/Practitioner: CRYSTAL SCOTT MS, FNP

Information about “1174169486” NPI (CRYSTAL SCOTT MS, FNP) exists in 1174169486 in HTML format HTML  |  1174169486 in plain Text format TXT  |  1174169486 in PDF (Portable Document Format) PDF  |  1174169486 in an XML format XML  formats.

NPI Number : 1174169486 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174169486",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SCOTT",
    "FirstName": "CRYSTAL",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS, FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7725 N 43RD AVE STE 111",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHOENIX",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85051-5775",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "623-931-9201",
    "MailingAddressFaxNumber": "623-931-2116",
    "FirstLinePracticeLocationAddress": "6539 LAS VEGAS BLVD S",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAS VEGAS",
    "PracticeLocationAddressStateName": "NV",
    "PracticeLocationAddressPostalCode": "89119-3222",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "702-755-2017",
    "PracticeLocationAddressFaxNumber": "205-449-6697",
    "EnumerationDate": "11/21/2019",
    "LastUpdateDate": "07/18/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "133V00000X",
          "TaxonomyName": "Registered Dietitian",
          "LicenseNumber": "46673",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WD0400X",
          "TaxonomyName": "Diabetes Educator Registered Nurse",
          "LicenseNumber": "831137",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.