Individual
SCOTT WILLIAM LISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2503 WALNUT ST STE 201, BOULDER, CO 80302-5745
(709) 872-5839
Mailing address
2075 SUMMIT ST, FRANKTOWN, CO 80116-8518
(970) 987-2583
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
1649070
CO
Other
Enumeration date
08/31/2020
Last updated
09/11/2023
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