Provider Demographics
NPI:1083024897
Name:SCOTT, KERI ANNE DENEISE (PA-C)
Entity type:Individual
Prefix:
First Name:KERI ANNE
Middle Name:DENEISE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 STONEFOREST DR STE 320
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-4881
Mailing Address - Country:US
Mailing Address - Phone:770-516-5199
Mailing Address - Fax:770-516-5188
Practice Address - Street 1:100 STONEFOREST DR STE 320
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-4881
Practice Address - Country:US
Practice Address - Phone:770-516-5199
Practice Address - Fax:770-516-5188
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA7143363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant