MEDICARE: DEBRA ANN 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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1487156873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA ANN SCOTT

Provider Business Mailing Address
First Line	:	76 WOODLAND DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-6414
Country	:	US
Telephone Number	:	731-217-6453
Fax Number	:

Provider Business Practice Location Address
First Line	:	76 WOODLAND DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-6414
Country	:	US
Telephone Number	:	731-217-6453
Fax Number	:

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

Provider Enumeration Date	:	03/02/2018
Last Update Date	:	03/02/2018

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Directions to “ DEBRA ANN SCOTT ” Practice Location

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