Provider Demographics
NPI:1467943803
Name:SCOTT, MARIE VERONICA (NP)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:VERONICA
Last Name:SCOTT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:VERONICA
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:410 CELEBRATION PL STE 106
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5432
Mailing Address - Country:US
Mailing Address - Phone:407-303-4829
Mailing Address - Fax:
Practice Address - Street 1:410 CELEBRATION PL STE 106
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5432
Practice Address - Country:US
Practice Address - Phone:407-303-4829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-22
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9174360363LA2200X
FLAPRN9174360363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health