Provider Demographics
NPI:1467412783
Name:SCOTT, LINDA SUSAN (NP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUSAN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 689022
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-9022
Mailing Address - Country:US
Mailing Address - Phone:866-398-7107
Mailing Address - Fax:615-465-2879
Practice Address - Street 1:1308 PALUXY RD
Practice Address - Street 2:SUITE 203
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-5689
Practice Address - Country:US
Practice Address - Phone:817-578-3904
Practice Address - Fax:817-578-8903
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX570021363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157770205Medicaid
TX268984YSGHMedicare PIN