Basic Information
| Provider Information | |||||||||
| NPI: | 1821082991 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8806 SWAN HILL RD | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402411150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5023390098 | ||||||||
| FaxNumber: | 5023390098 | ||||||||
| Practice Location | |||||||||
| Address1: | 4003 KRESGE WAY | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402074652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028954263 | ||||||||
| FaxNumber: | 5028995488 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 1042471 | KY | Y | Nursing Service Providers | Registered Nurse |
ID Information
| ID | Type | State | Issuer | Description | 000000223402 | 01 | KY | ANTHEM BC/BS | OTHER |