Provider Demographics
NPI:1205173374
Name:SCOTT, LATORA GRANT (PHD, RN)
Entity type:Individual
Prefix:DR
First Name:LATORA
Middle Name:GRANT
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PHD, RN
Other - Prefix:
Other - First Name:LATORA
Other - Middle Name:LUDELL
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, RN
Mailing Address - Street 1:523 REBECCA DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3061
Mailing Address - Country:US
Mailing Address - Phone:469-516-2686
Mailing Address - Fax:
Practice Address - Street 1:523 REBECCA DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3061
Practice Address - Country:US
Practice Address - Phone:469-516-2686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX695349163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX695349OtherTEXAS BOARD OF NURSING