Provider Demographics
NPI:1114435385
Name:SCCOTT, WINSTON HIERI
Entity Type:Individual
Prefix:
First Name:WINSTON
Middle Name:HIERI
Last Name:SCCOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 ALMA LIDIA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-0725
Mailing Address - Country:US
Mailing Address - Phone:702-244-0900
Mailing Address - Fax:
Practice Address - Street 1:2408 ALMA LIDIA AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-0725
Practice Address - Country:US
Practice Address - Phone:702-244-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant