Provider Demographics
NPI:1114691615
Name:SCOTT, VICKIE MICHELLE
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:MICHELLE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23194
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31403-3194
Mailing Address - Country:US
Mailing Address - Phone:912-596-4917
Mailing Address - Fax:912-349-5355
Practice Address - Street 1:2009 BOLLING ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-2515
Practice Address - Country:US
Practice Address - Phone:912-596-4917
Practice Address - Fax:912-349-5355
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health