Provider Demographics
NPI:1891449286
Name:SCOTT, STEPHANIE ANTOINETTE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANTOINETTE
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 1:2211 FOXBOURNE RD APT 19
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2025
Mailing Address - Country:US
Mailing Address - Phone:419-320-5135
Mailing Address - Fax:
Practice Address - Street 1:2211 FOXBOURNE RD APT 19
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2025
Practice Address - Country:US
Practice Address - Phone:419-320-5135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-05
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider