Individual
NINA D SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3512 STELLHORN RD, SUITE 100, FORT WAYNE, IN 46815-4631
(260) 483-9081
(260) 483-9196
Mailing address
3512 STELLHORN RD, SUITE 100, FORT WAYNE, IN 46815-4631
(260) 483-9081
(260) 483-9196
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28104970
IN
363L00000X
Nurse Practitioner
Primary
71000026
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100359310A
—
IN
01
—
500005028
RR MEDICARE
IN
Enumeration date
12/13/2005
Last updated
03/21/2017
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