Provider Demographics
NPI:1619241908
Name:SMITH, SCOTT ANDREW (MSN APRN-CNP ACNP-BC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ANDREW
Last Name:SMITH
Suffix:
Gender:M
Credentials:MSN APRN-CNP ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7027
Mailing Address - Country:US
Mailing Address - Phone:207-795-7575
Mailing Address - Fax:207-344-0350
Practice Address - Street 1:300 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7027
Practice Address - Country:US
Practice Address - Phone:207-795-7575
Practice Address - Fax:207-344-0350
Is Sole Proprietor?:No
Enumeration Date:2012-03-04
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP 151027363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care