Provider Demographics
NPI:1336882331
Name:SCOTT, EMMA GRACE (NP-C)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:GRACE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:PENNS GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08069-1226
Mailing Address - Country:US
Mailing Address - Phone:856-628-3293
Mailing Address - Fax:
Practice Address - Street 1:5 ROUTE 45 STE 101
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-2000
Practice Address - Country:US
Practice Address - Phone:856-887-3005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01298300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner