Provider Demographics
NPI:1689345845
Name:SCOTT, ASHLEY NICOLE (USCG IDHS)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:USCG IDHS
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:MCPHEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:632 COAST GUARD DR
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-2048
Mailing Address - Country:US
Mailing Address - Phone:231-597-2030
Mailing Address - Fax:
Practice Address - Street 1:632 COAST GUARD DR
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-2048
Practice Address - Country:US
Practice Address - Phone:231-597-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC077006164W00000X
1710I1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman
No164W00000XNursing Service ProvidersLicensed Practical Nurse