MEDICARE: ANITA SCOFIELD

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	93780-30	WI

General Provider Information

NPI Number	:	1700209657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITA SCOFIELD

Provider Business Mailing Address
First Line	:	508 W SOUTH ST
Second Line	:
City	:	LOYAL
State	:	WI
Zip	:	54446-9509
Country	:	US
Telephone Number	:	715-503-1016
Fax Number	:

Provider Business Practice Location Address
First Line	:	508 W SOUTH ST
Second Line	:
City	:	LOYAL
State	:	WI
Zip	:	54446-9509
Country	:	US
Telephone Number	:	715-503-1016
Fax Number	:

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

Provider Enumeration Date	:	01/29/2014
Last Update Date	:	01/29/2014

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Directions to “ ANITA SCOFIELD ” Practice Location

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