Individual
KEESHA SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14780 W MOUNTAIN VIEW BLVD, SUITE 110, SURPRISE, AZ 85374-7280
(623) 374-7774
Mailing address
6020 W WOOD ST, PHOENIX, AZ 85043
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP5078
AZ
Other
Enumeration date
07/10/2014
Last updated
11/19/2014
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