Provider Demographics
NPI:1760603252
Name:SCOTT, LAURIE ANNE (NP)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:ANNE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6408
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85261-6408
Mailing Address - Country:US
Mailing Address - Phone:480-563-6400
Mailing Address - Fax:480-563-8009
Practice Address - Street 1:9787 N 91ST ST STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5088
Practice Address - Country:US
Practice Address - Phone:480-563-6400
Practice Address - Fax:480-563-8009
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN157181363LF0000X
AZAP3337363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ133155Medicare UPIN