Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 04833 | OH |
NPI | 1023214673 |
---|---|
Provider Name | Suzanne Scott |
First Address | Columbus, OH 43235-2725 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2007 |
Last Update Date | 20/09/2016 |