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General NPI Number Information
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NPI Number | 1669844932
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Entity Type | Individual
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Provider Name | SCOTT THOUVENOT
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Gender | Male
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 226 S WOODS MILL RD SUITE 43 WEST
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3662
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Country | US
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Telephone | 314-205-6444
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 LOUISVILLE AVE APT 2S
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City | SAINT LOUIS
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State | MO
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Zip | 63139-3342
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Country | US
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Telephone | 314-803-6085
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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 | 2015036191
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License Number State | MO
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