Provider Demographics
NPI:1447133897
Name:SCOTT, BRANDY E
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:E
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3919 TILLESON WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-6555
Mailing Address - Country:US
Mailing Address - Phone:760-985-2637
Mailing Address - Fax:
Practice Address - Street 1:3919 TILLESON WAY
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-6555
Practice Address - Country:US
Practice Address - Phone:760-985-2637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker