Provider Demographics
NPI:1619200516
Name:SCOTT, JANA LYNN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JANA
Middle Name:LYNN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:LYNN
Other - Last Name:JACOBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:P.O. BOX 1706
Mailing Address - Street 2:
Mailing Address - City:FOREST LAKES
Mailing Address - State:AZ
Mailing Address - Zip Code:85931
Mailing Address - Country:US
Mailing Address - Phone:480-433-4156
Mailing Address - Fax:
Practice Address - Street 1:9897 W MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-1621
Practice Address - Country:US
Practice Address - Phone:623-474-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3453363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily