Basic Information
| Provider Information | |||||||||
| NPI: | 1255875548 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINSCOTT | ||||||||
| FirstName: | TAMI | ||||||||
| MiddleName: | |||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1251 CLARK ST | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437259612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404390733 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 E 8TH ST STE 121 | ||||||||
| Address2: | |||||||||
| City: | MARIETTA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 457503379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403747464 | ||||||||
| FaxNumber: | 7403731562 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2016 | ||||||||
| LastUpdateDate: | 08/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | NP-020139 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 0199638 | 05 | OH | MEDICAID |