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General NPI Number Information
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NPI Number | 1679359699
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Entity Type | Individual
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Provider Name | BREONNA SCOTT
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Gender | Female
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 265 BROOKVIEW CENTRE WAY STE 203
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City | KNOXVILLE
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State | TN
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Zip | 37919-4052
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Country | US
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Telephone | 800-861-4093
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Fax |
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Provider Business Mailing Address
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Address Line | 647 GULFWOOD RD
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City | KNOXVILLE
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State | TN
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Zip | 37923-2213
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Country | US
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Telephone | 865-599-1930
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 34653
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License Number State | TN
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