Provider Demographics
NPI:1063821510
Name:SCOTT, PATRICIA (RN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 STATE ROUTE 69
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-1742
Mailing Address - Country:US
Mailing Address - Phone:315-281-8103
Mailing Address - Fax:
Practice Address - Street 1:758 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-3942
Practice Address - Country:US
Practice Address - Phone:315-334-5180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY353049163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool