Provider Demographics
NPI:1245695667
Name:SCOTT, ROBIN (CRNP)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5736 BLACHLY WAY APT 3
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-2455
Mailing Address - Country:US
Mailing Address - Phone:925-808-0305
Mailing Address - Fax:
Practice Address - Street 1:5900 COYLE AVE STE A
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0400
Practice Address - Country:US
Practice Address - Phone:916-330-4447
Practice Address - Fax:916-414-9054
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1104465363LF0000X
CA95005479363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily