MEDICARE: CAROL ANNE SCOTT RN

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	163WC0400X	Case Management Registered Nurse	RN1649877	CO

General Provider Information

NPI Number	:	1194439349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL ANNE SCOTT RN

Provider Business Mailing Address
First Line	:	1680 FELKINS STREET
Second Line	:	BLDG 1226
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80913
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1680 FELKINS STREET
Second Line	:	BLDG 1226
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80913
Country	:	US
Telephone Number	:	719-503-7710
Fax Number	:

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

Provider Enumeration Date	:	01/12/2023
Last Update Date	:	01/12/2023

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