MEDICARE: MRS. JENNIFER HAITH SCOTT FNP-BC

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	363LF0000X	Family Nurse Practitioner	ARNP9180682	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750587002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER HAITH SCOTT FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 13833
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19101-3833
Country	:	US
Telephone Number	:	352-265-0301
Fax Number	:	352-265-0627

Provider Business Practice Location Address
First Line	:	221 SW STONEGATE TER
Second Line	:	SUITE 101
City	:	LAKE CITY
State	:	FL
Zip	:	32024-3463
Country	:	US
Telephone Number	:	386-292-7744
Fax Number	:	386-719-7066

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	11/20/2020

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