MEDICARE: MARIE SCOTT R.N.

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	163W00000X	Registered Nurse	102681	WI
2	363LA2200X	Adult Health Nurse Practitioner	5389-33	WI

General Provider Information

NPI Number	:	1639131147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE SCOTT R.N.

Provider Business Mailing Address
First Line	:	4906 S HILL DR
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-4804
Country	:	US
Telephone Number	:	608-233-7275
Fax Number	:

Provider Business Practice Location Address
First Line	:	4906 S HILL DR
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-4804
Country	:	US
Telephone Number	:	608-233-7275
Fax Number	:

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

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	09/09/2013

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