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Individual
CRYSTAL SCOTT
Active
Individual
CRYSTAL SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1822
KY
363AM0700X
Medical Physician Assistant
PA1822
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100294880
—
KY
Enumeration date
07/29/2013
Last updated
03/27/2015
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