Provider Demographics
NPI:1649338849
Name:SCOTT, BRANDY MICHELLE (PA C, MPAS)
Entity type:Individual
Prefix:MS
First Name:BRANDY
Middle Name:MICHELLE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PA C, MPAS
Other - Prefix:
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Mailing Address - Street 1:1329 W WALNUT AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-3983
Mailing Address - Country:US
Mailing Address - Phone:423-778-9901
Mailing Address - Fax:423-778-9902
Practice Address - Street 1:1329 W WALNUT AVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3982
Practice Address - Country:US
Practice Address - Phone:423-778-9901
Practice Address - Fax:423-778-9902
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA003742363AM0700X, 363AM0700X
NC0010-01056363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical