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General NPI Number Information
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NPI Number | 1891369245
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Entity Type | Individual
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Provider Name | ZACHARY LEE SCOTT APRN-CNP
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Gender | Male
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Dates
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Enumeration Date | 05/19/2021
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Last Update Date | 05/19/2021
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Provider Practice Location Address
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Address Line | 237 S LOCUST ST
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City | NOWATA
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State | OK
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Zip | 74048-3660
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Country | US
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Telephone | 918-273-5416
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MEADOW LN
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City | COFFEYVILLE
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State | KS
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Zip | 67337-7504
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Country | US
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Telephone | 620-515-0555
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Fax | 918-273-5416
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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 | 201984
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License Number State | OK
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