Provider Demographics
NPI:1518206390
Name:SCOTT, BILLIE J (CRNA)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:J
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:BILLIE
Other - Middle Name:J
Other - Last Name:STIMAC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:23 N BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:OMAK
Mailing Address - State:WA
Mailing Address - Zip Code:98841-5102
Mailing Address - Country:US
Mailing Address - Phone:832-421-0176
Mailing Address - Fax:530-229-3703
Practice Address - Street 1:23 N BIRCH ST
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841-5102
Practice Address - Country:US
Practice Address - Phone:832-421-0176
Practice Address - Fax:530-229-3703
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID76205367500000X
WAAP60330344367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered