Provider Demographics
NPI:1811414675
Name:SCOTT, AUDRA ROWELL
Entity Type:Individual
Prefix:
First Name:AUDRA
Middle Name:ROWELL
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KERSHAW COUNTY HEALTH DEPARTMENT
Mailing Address - Street 2:1116 CHURCH ST
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-3502
Mailing Address - Country:US
Mailing Address - Phone:803-425-6012
Mailing Address - Fax:
Practice Address - Street 1:KERSHAW COUNTY HEALTH DEPARTMENT
Practice Address - Street 2:1116 CHURCH STREET
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020
Practice Address - Country:US
Practice Address - Phone:803-425-6012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC65217163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse