Provider Demographics
NPI:1235805110
Name:SCOTT, MYRA
Entity Type:Individual
Prefix:
First Name:MYRA
Middle Name:
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 1:2340 19TH ST SW UPPR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-2012
Mailing Address - Country:US
Mailing Address - Phone:267-776-5462
Mailing Address - Fax:234-231-1442
Practice Address - Street 1:2340 19TH ST SW UPPR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314-2012
Practice Address - Country:US
Practice Address - Phone:267-776-5462
Practice Address - Fax:234-231-1442
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide