Provider Demographics
NPI:1710056494
Name:SCOTT, CAROL FOSTER (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:FOSTER
Last Name:SCOTT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:CAROL
Other - Middle Name:LYNN
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:186 BAMBI LANE
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28694
Mailing Address - Country:US
Mailing Address - Phone:336-877-1502
Mailing Address - Fax:
Practice Address - Street 1:870 STATE FARM RD
Practice Address - Street 2:BLUE RIDGE ENT SUITE 101
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607
Practice Address - Country:US
Practice Address - Phone:828-264-4545
Practice Address - Fax:828-264-4544
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8932979Medicaid
32979OtherBC
NC8932979Medicaid
32979OtherBC