Provider Demographics
NPI:1033379680
Name:LUTHER, SCARLET (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SCARLET
Middle Name:
Last Name:LUTHER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:SCARLET
Other - Middle Name:
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:6639 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:PORTAGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14536-9711
Mailing Address - Country:US
Mailing Address - Phone:585-468-2336
Mailing Address - Fax:
Practice Address - Street 1:6639 CHURCH ST
Practice Address - Street 2:
Practice Address - City:PORTAGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:14536-9711
Practice Address - Country:US
Practice Address - Phone:585-468-2336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249564-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse