Provider Demographics
NPI:1275219461
Name:SCOTT, FELISHA M
Entity Type:Individual
Prefix:
First Name:FELISHA
Middle Name:M
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 132
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-0132
Mailing Address - Country:US
Mailing Address - Phone:833-733-8327
Mailing Address - Fax:
Practice Address - Street 1:605 GENERAL HARTINGER PKWY
Practice Address - Street 2:
Practice Address - City:MIDDLEPORT
Practice Address - State:OH
Practice Address - Zip Code:45760-1255
Practice Address - Country:US
Practice Address - Phone:833-733-8327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker