Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | 28072771A | IN |
Y | 363LW0102X | Nurse Practitioner - Women's Health | 71004103A | IN |
NPI | 1023454972 |
---|---|
Provider Name | Robin Annette Swantack Scott |
First Address | Indianapolis, IN 46280-2004 |
Second Address | Indianapolis, IN 46280-2004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2013 |
Last Update Date | 20/05/2013 |