Provider Demographics
NPI:1326730706
Name:SCOTT, FELECIA SHAVON (MA, PHLEBOTOMIST)
Entity Type:Individual
Prefix:
First Name:FELECIA
Middle Name:SHAVON
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MA, PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SWEETSHRUB LN
Mailing Address - Street 2:
Mailing Address - City:SAINT MATTHEWS
Mailing Address - State:SC
Mailing Address - Zip Code:29135-8243
Mailing Address - Country:US
Mailing Address - Phone:803-456-0167
Mailing Address - Fax:
Practice Address - Street 1:100 SWEETSHRUB LN
Practice Address - Street 2:
Practice Address - City:SAINT MATTHEWS
Practice Address - State:SC
Practice Address - Zip Code:29135-8243
Practice Address - Country:US
Practice Address - Phone:803-456-0167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR7H7L5Y2246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy