Provider Demographics
NPI:1699017749
Name:SCOTT, LA TAURA ALISA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LA TAURA
Middle Name:ALISA
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:LA TAURA
Other - Middle Name:ALISA
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:170 GARDINER AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611-2931
Mailing Address - Country:US
Mailing Address - Phone:585-529-4829
Mailing Address - Fax:
Practice Address - Street 1:170 GARDINER AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-2931
Practice Address - Country:US
Practice Address - Phone:585-529-4829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302193164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse