Provider Demographics
NPI:1023454972
Name:SCOTT, ROBIN ANNETTE SWANTACK (NP)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:ANNETTE SWANTACK
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 1:10610 N PENNSYLVANIA ST
Mailing Address - Street 2:SUIITE 101
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46280-2004
Mailing Address - Country:US
Mailing Address - Phone:317-814-4110
Mailing Address - Fax:
Practice Address - Street 1:10610 N PENNSYLVANIA ST
Practice Address - Street 2:SUIITE 101
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-2004
Practice Address - Country:US
Practice Address - Phone:317-814-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28072771A363LW0102X
IN71004103A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health