Provider Demographics
NPI:1336101849
Name:SCOTT, GRETCHEN D (CNP)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:D
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CNP
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 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1205 S. GRANGE AVE
Practice Address - Street 2:STE 201
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-0414
Practice Address - Country:US
Practice Address - Phone:605-328-8100
Practice Address - Fax:605-328-8101
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDSDRNR028760363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6828390Medicaid
SDS40680Medicare PIN
P71349Medicare UPIN