Basic Information
| Provider Information | |||||||||
| NPI: | 1740343490 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | THECLY | ||||||||
| MiddleName: | HINES | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RNC, CNM, WHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | NAVAL MEDICAL CENTER SAN DIEGO | ||||||||
| Address2: | 34800 BOB WILSON DR | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195326400 | ||||||||
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| Practice Location | |||||||||
| Address1: | NAVAL MEDICAL CENTER SAN DIEGO | ||||||||
| Address2: | 34800 BOB WILSON DR | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921340001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195326400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2006 | ||||||||
| LastUpdateDate: | 09/17/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | ANT 9195366 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.