Provider Demographics
NPI:1366838716
Name:GARRETT, SCOTT LEROY (RN)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:LEROY
Last Name:GARRETT
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8969 E GLENMONT DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-4863
Mailing Address - Country:US
Mailing Address - Phone:520-247-3120
Mailing Address - Fax:
Practice Address - Street 1:8969 E GLENMONT DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-4863
Practice Address - Country:US
Practice Address - Phone:520-247-3120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN166165163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse