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General NPI Number Information
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NPI Number | 1386591915
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Entity Type | Individual
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Provider Name | SCOTT LOAN
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Gender | Male
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 302 SATELLITE BLVD NE STE 109&110
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City | SUWANEE
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State | GA
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Zip | 30024-7181
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Country | US
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Telephone | 678-369-9399
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Fax | 833-464-3867
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Provider Business Mailing Address
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Address Line | 2991 MCCANNON MILL DR
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City | DACULA
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State | GA
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Zip | 30019-5417
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Country | US
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Telephone | 404-910-7986
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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 | RN298119
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License Number State | GA
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