MEDICARE: KRISHAWNDA JANELLE SCOTT APRN-CNP, PMHNP-BC

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	390200000X	Student in an Organized Health Care Education/Training Program
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0026974	OH
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	4014457	KY

General Provider Information

NPI Number	:	1326669904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISHAWNDA JANELLE SCOTT APRN-CNP, PMHNP-BC

Provider Business Mailing Address
First Line	:	8517 MOONGLOW CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-1116
Country	:	US
Telephone Number	:	513-790-4792
Fax Number	:	970-585-8304

Provider Business Practice Location Address
First Line	:	8517 MOONGLOW CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-1116
Country	:	US
Telephone Number	:	513-790-4792
Fax Number	:	970-585-8304

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

Provider Enumeration Date	:	05/05/2020
Last Update Date	:	07/30/2025

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