Provider Demographics
NPI:1497050256
Name:SCOTT, DEBORAH MASSEY (FNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MASSEY
Last Name:SCOTT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4593 MOUNT GILLESPIE DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8310
Mailing Address - Country:US
Mailing Address - Phone:901-290-9033
Mailing Address - Fax:
Practice Address - Street 1:60 GERMANTOWN CT
Practice Address - Street 2:SUITE 200
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4238
Practice Address - Country:US
Practice Address - Phone:901-756-1216
Practice Address - Fax:901-756-1412
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000098624363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily