Provider Demographics
NPI:1205438223
Name:SCOTT, TOMIKA EJUAN
Entity type:Individual
Prefix:
First Name:TOMIKA
Middle Name:EJUAN
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 1:2108 STONEY CT
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-4213
Mailing Address - Country:US
Mailing Address - Phone:614-962-4081
Mailing Address - Fax:
Practice Address - Street 1:1322 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1697
Practice Address - Country:US
Practice Address - Phone:614-962-4081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker