Provider Demographics
NPI:1225404494
Name:SCOTT, STEPHANIE (LVN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 LONG PRAIRIE RD
Mailing Address - Street 2:140
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1525
Mailing Address - Country:US
Mailing Address - Phone:972-691-2388
Mailing Address - Fax:972-691-2766
Practice Address - Street 1:4001 LONG PRAIRIE RD
Practice Address - Street 2:140
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1525
Practice Address - Country:US
Practice Address - Phone:972-691-2388
Practice Address - Fax:972-691-2766
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX307368164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse