Provider Demographics
NPI:1760424709
Name:SCOTT, LORRAINE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:LORRAINE
Other - Middle Name:
Other - Last Name:ZOVI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7667
Mailing Address - Country:US
Mailing Address - Phone:541-842-7704
Mailing Address - Fax:541-930-5572
Practice Address - Street 1:1159 EAGLE DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-8020
Practice Address - Country:US
Practice Address - Phone:970-219-5223
Practice Address - Fax:970-449-1606
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA184661363AM0700X, 363A00000X
COPA.0000618363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COS94243Medicare UPIN