Provider Demographics
NPI:1437474129
Name:SCOGGINS, PAULA KAY (FNP-C, MSN)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:KAY
Last Name:SCOGGINS
Suffix:
Gender:F
Credentials:FNP-C, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4221 W VILLA RITA DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-2514
Mailing Address - Country:US
Mailing Address - Phone:209-733-0230
Mailing Address - Fax:
Practice Address - Street 1:4221 W VILLA RITA DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-2514
Practice Address - Country:US
Practice Address - Phone:209-733-0230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3603363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care