Provider Demographics
NPI:1033703178
Name:SCOTT, NICOLE (WHNP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8571 W CINNABAR AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-3151
Mailing Address - Country:US
Mailing Address - Phone:661-964-7707
Mailing Address - Fax:
Practice Address - Street 1:1313 E OSBORN RD STE 250
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5699
Practice Address - Country:US
Practice Address - Phone:602-265-9161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ210486163WW0101X
AZ300876363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory