MEDICARE: TIFFANY L SCOTT NP

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	363LF0000X	Family Nurse Practitioner	0024184701	WA
2	363LP0222X	Critical Care Pediatric Nurse Practitioner	RN236199	GA

General Provider Information

NPI Number	:	1255832754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY L SCOTT NP

Provider Business Mailing Address
First Line	:	1001 CENTERBROOKE LN STE 100
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23434-8663
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 CENTERBROOKE LN STE 100
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23434-8663
Country	:	US
Telephone Number	:	757-702-8105
Fax Number	:

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

Provider Enumeration Date	:	02/21/2018
Last Update Date	:	12/11/2024

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Directions to “ TIFFANY L SCOTT NP” Practice Location

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