Basic Information
| Provider Information | |||||||||
| NPI: | 1942833769 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | FELICIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5354 REYNOLDS ST | ||||||||
| Address2: | SUITE 424 | ||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9128195999 | ||||||||
| FaxNumber: | 9128195980 | ||||||||
| Practice Location | |||||||||
| Address1: | 5354 REYNOLDS ST | ||||||||
| Address2: | SUITE 424 | ||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9128195999 | ||||||||
| FaxNumber: | 9128195980 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2020 | ||||||||
| LastUpdateDate: | 02/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN189696 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.