Provider Demographics
NPI:1689037020
Name:SCOTT, CHARTELE (LPN)
Entity Type:Individual
Prefix:
First Name:CHARTELE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PHILLIPS ST
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-2613
Mailing Address - Country:US
Mailing Address - Phone:315-373-7703
Mailing Address - Fax:
Practice Address - Street 1:6120 ROCK CUT RD
Practice Address - Street 2:LOT 57
Practice Address - City:JAMESVILLE
Practice Address - State:NY
Practice Address - Zip Code:13078-9324
Practice Address - Country:US
Practice Address - Phone:315-640-0689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-02
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY830027163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse