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NPI Code Detail

MEDICARE: MR. SCOTT EDWARD EWING FNP-BC

MEDICARE: MR. SCOTT EDWARD EWING FNP-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
1207Q00000XFamily Medicine PhysicianAP10115AZ
2363LF0000XFamily Nurse PractitionerAP10115AZ

General Provider Information

NPI Number : 1447787882
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SCOTT EDWARD EWING FNP-BC
Provider Business Mailing Address
First Line : 1648 HIGHWAY 95
Second Line :
City : BULLHEAD CITY
State : AZ
Zip : 86442-7906
Country : US
Telephone Number : 928-758-4114
Fax Number : 928-758-4650
Provider Business Practice Location Address
First Line : 1648 HIGHWAY 95
Second Line :
City : BULLHEAD CITY
State : AZ
Zip : 86442-7906
Country : US
Telephone Number : 928-758-4114
Fax Number : 928-758-4650
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2017
Last Update Date : 04/30/2021

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Directions to “ MR. SCOTT EDWARD EWING FNP-BC” Practice Location

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