Individual
MS. MARY RYAN SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3 SUPERIOR DR STE 100B, SUPERIOR, CO 80027-8653
(303) 415-8940
(303) 425-9259
Mailing address
2820 TABLE MESA DR, BOULDER, CO 80305-5749
(505) 670-5050
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3912
CO
363LF0000X
Family Nurse Practitioner
R33217
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00077947
—
NM
Enumeration date
03/07/2007
Last updated
09/29/2022
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