Provider Demographics
NPI:1295252302
Name:SCOTT, JONATHAN JASON (RN)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:JASON
Last Name:SCOTT
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 DOWNEY OAK CIR
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:DE
Mailing Address - Zip Code:19934-5213
Mailing Address - Country:US
Mailing Address - Phone:302-724-0487
Mailing Address - Fax:
Practice Address - Street 1:424 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1462
Practice Address - Country:US
Practice Address - Phone:302-645-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0046722163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEL1-0046722OtherNURSING LICENSE