Individual
IVAN EARL SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2144 CECIL B MOORE AVE, PHILADELPHIA, PA 19121-4014
(215) 320-6187
Mailing address
2144 CECIL B MOORE AVE, PHILADELPHIA, PA 19121-4014
(215) 320-6187
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP031835
PA
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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