Provider Demographics
NPI:1417907841
Name:HUNT-SCOTT, KWANITA LYNETTE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KWANITA
Middle Name:LYNETTE
Last Name:HUNT-SCOTT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-1692
Mailing Address - Country:US
Mailing Address - Phone:803-368-1032
Mailing Address - Fax:
Practice Address - Street 1:455 LAKESHORE PKWY
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4205
Practice Address - Country:US
Practice Address - Phone:803-909-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC801363AM0700X
SCA801363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCA801OtherPA LICENSE
SCAA01358677Medicare PIN