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General NPI Number Information
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NPI Number | 1174169486
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Entity Type | Individual
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Provider Name | CRYSTAL SCOTT MS, FNP
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Gender | Female
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 6539 LAS VEGAS BLVD S
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City | LAS VEGAS
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State | NV
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Zip | 89119-3222
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Country | US
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Telephone | 702-755-2017
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Fax | 205-449-6697
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Provider Business Mailing Address
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Address Line | 7725 N 43RD AVE STE 111
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City | PHOENIX
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State | AZ
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Zip | 85051-5775
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Country | US
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Telephone | 623-931-9201
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Fax | 623-931-2116
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 46673
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 831137
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License Number State | NV
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