Provider Demographics
NPI:1740782762
Name:SCOTT, MELISSA (AGACNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:MELSISA
Other - Middle Name:
Other - Last Name:MCCURDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP
Mailing Address - Street 1:5012 S US HIGHWAY 75 STE 100
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4597
Mailing Address - Country:US
Mailing Address - Phone:903-416-6325
Mailing Address - Fax:
Practice Address - Street 1:5012 S US HIGHWAY 75 STE 100
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4597
Practice Address - Country:US
Practice Address - Phone:903-416-2942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX867589363LA2100X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care