MEDICARE: SCOTT CRNP INC

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

General Provider Information

NPI Number	:	1669063939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT CRNP INC

Provider Business Mailing Address
First Line	:	178 WINDOVER DR
Second Line	:
City	:	MIDLAND
State	:	PA
Zip	:	15059-2216
Country	:	US
Telephone Number	:	412-974-1075
Fax Number	:

Provider Business Practice Location Address
First Line	:	178 WINDOVER DR
Second Line	:
City	:	MIDLAND
State	:	PA
Zip	:	15059-2216
Country	:	US
Telephone Number	:	724-888-2186
Fax Number	:	724-888-2443

Authorized Official
Title or Position	:	OWNER-PRESIDENT
Name	:	KELLY A SCOTT
Credential	:	CRNP, PMHNP-BC
Telephone Number	:	412-974-1075

Provider Enumeration Date	:	01/29/2021
Last Update Date	:	11/02/2023

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