Individual
SCOTT EDWARD WITHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(972) 310-7339
Mailing address
102 KELVINGTON DR, ANNA, TX 75409-0056
(972) 310-7339
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
648384
TX
363LF0000X
Family Nurse Practitioner
AP110973
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00X940
MEDICARE GROUP PTAN
TX
Enumeration date
06/16/2006
Last updated
09/14/2020
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