Provider Demographics
NPI:1629363122
Name:SCOTT, ALLISON LYNNE (FNP-C)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:LYNNE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:LYNNE
Other - Last Name:FIPPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2936 N ELM ST STE 102
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2981
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2936 N ELM ST STE 102
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2981
Practice Address - Country:US
Practice Address - Phone:910-671-6619
Practice Address - Fax:910-608-0487
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005189363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5005189OtherMEDICAL
MS2391580OtherDEA