Provider Demographics
NPI:1255964250
Name:SCOTT, ANNA LYNN (PA)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:LYNN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:LYNN
Other - Last Name:ROSSELIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:614-544-2815
Mailing Address - Fax:614-544-2816
Practice Address - Street 1:5141 W BROAD ST STE 150
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1984
Practice Address - Country:US
Practice Address - Phone:614-544-1401
Practice Address - Fax:614-544-1403
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0430981Medicaid