Provider Demographics
NPI:1730319393
Name:SCOTT, CHRISTINE INEZ (LPN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:INEZ
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:SCOTT
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:101 RIDGESIDE CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-1756
Mailing Address - Country:US
Mailing Address - Phone:864-386-1391
Mailing Address - Fax:
Practice Address - Street 1:101 RIDGESIDE CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-1756
Practice Address - Country:US
Practice Address - Phone:864-386-1391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCP 10104164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse