Provider Demographics
NPI:1245798727
Name:SCOTT, BRANDON EVERETT (FNP)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:EVERETT
Last Name:SCOTT
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 887
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-0887
Mailing Address - Country:US
Mailing Address - Phone:864-366-5011
Mailing Address - Fax:
Practice Address - Street 1:420 THOMSON CIR
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29620-5656
Practice Address - Country:US
Practice Address - Phone:864-366-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC222778363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily