Provider Demographics
NPI:1164595948
Name:AIENA, SCOT GUILOTT (CRNA)
Entity Type:Individual
Prefix:
First Name:SCOT
Middle Name:GUILOTT
Last Name:AIENA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSVILLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28480-1913
Mailing Address - Country:US
Mailing Address - Phone:910-509-1814
Mailing Address - Fax:
Practice Address - Street 1:607 BEAMAN ST
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2603
Practice Address - Country:US
Practice Address - Phone:910-590-8729
Practice Address - Fax:910-590-2321
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21059367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC154625OtherNC NURSING LICENSE
NC8051212Medicaid
NC2601252AMedicare ID - Type Unspecified
NC8051212Medicaid