Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 18002 | OH |
NPI | 1003287939 |
---|---|
Provider Name | Mrs. Christina Scott |
First Address | Mentor, OH 44060-8723 |
Second Address | Mentor, OH 44060-8723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2015 |
Last Update Date | 26/02/2021 |