Provider Demographics
NPI:1295537686
Name:SCOUT KETAMINE AND WELLNESS
Entity type:Organization
Organization Name:SCOUT KETAMINE AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT-HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:559-213-1344
Mailing Address - Street 1:1705 EDELWEISS DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3547
Mailing Address - Country:US
Mailing Address - Phone:559-213-1344
Mailing Address - Fax:
Practice Address - Street 1:220 COMMERCIAL DR STE B
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-2566
Practice Address - Country:US
Practice Address - Phone:254-251-3411
Practice Address - Fax:254-477-7080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center