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General NPI Number Information
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NPI Number | 1336574565
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Entity Type | Individual
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Provider Name | SCOTT EDWARD AVERY ACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 09/06/2013
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Last Update Date | 07/20/2024
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Provider Practice Location Address
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Address Line | 11803 JEFFERSON AVE STE 205
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2565
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Country | US
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Telephone | 757-736-9860
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Fax |
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Provider Business Mailing Address
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Address Line | 11803 JEFFERSON AVE STE 205
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2565
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Country | US
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Telephone | 757-736-9860
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0001247949
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024171326
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License Number State | VA
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