MEDICARE: DR. MONIQUE SCOTT NURSE PRACTITIONER

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	401859	NY

General Provider Information

NPI Number	:	1508096561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONIQUE SCOTT NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	3 E EVERGREEN RD UNIT 101
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-5146
Country	:	US
Telephone Number	:	845-259-6910
Fax Number	:	845-589-5171

Provider Business Practice Location Address
First Line	:	200 W MARTIN LUTHER KING BLVD STE 1000
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37402-2571
Country	:	US
Telephone Number	:	423-451-8322
Fax Number	:	423-205-5087

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

Provider Enumeration Date	:	07/23/2009
Last Update Date	:	09/11/2025

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