Provider Demographics
NPI:1629689047
Name:SCOTT, MAKIA (CNA)
Entity Type:Individual
Prefix:
First Name:MAKIA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 SOUTH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-2046
Mailing Address - Country:US
Mailing Address - Phone:267-254-0664
Mailing Address - Fax:267-909-9100
Practice Address - Street 1:818 SOUTH ST APT 4
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-2046
Practice Address - Country:US
Practice Address - Phone:267-254-0664
Practice Address - Fax:267-909-9100
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA20016601374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide