MEDICARE: CONNIE ELAINE SCOTT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	RN162389	GA

General Provider Information

NPI Number	:	1184579336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNIE ELAINE SCOTT

Provider Business Mailing Address
First Line	:	908 W OGLETHORPE BLVD
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31701-2722
Country	:	US
Telephone Number	:	229-255-9717
Fax Number	:	912-303-7855

Provider Business Practice Location Address
First Line	:	908 W OGLETHORPE BLVD
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31701-2722
Country	:	US
Telephone Number	:	229-255-9717
Fax Number	:	912-303-7855

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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