Provider Demographics
NPI:1891360640
Name:LEE-SCOTT, GLENDA BETH
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:BETH
Last Name:LEE-SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GLENDA
Other - Middle Name:BETH
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:PO BOX 21007
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35813-5007
Mailing Address - Country:US
Mailing Address - Phone:256-801-6056
Mailing Address - Fax:256-801-6221
Practice Address - Street 1:9000 BAILEY COVE RD SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-4002
Practice Address - Country:US
Practice Address - Phone:256-428-4900
Practice Address - Fax:256-428-4912
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-0923050363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily