Provider Demographics
NPI:1407133663
Name:KATSCOTT LLC
Entity Type:Organization
Organization Name:KATSCOTT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:904-705-3798
Mailing Address - Street 1:4217 BAYMEADOWS RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4676
Mailing Address - Country:US
Mailing Address - Phone:904-332-7431
Mailing Address - Fax:904-332-7408
Practice Address - Street 1:4217 BAYMEADOWS RD
Practice Address - Street 2:SUITE 3
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4676
Practice Address - Country:US
Practice Address - Phone:904-332-7431
Practice Address - Fax:904-332-7408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9172712363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty