Individual
MRS. SUZETTE SHARLETTE SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
151 LAKE VALLEY DR, LOGANVILLE, GA 30052-7828
(770) 605-7022
Mailing address
151 LAKE VALLEY DR, LOGANVILLE, GA 30052-7828
(770) 605-7022
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN179096
GA
Other
Enumeration date
09/30/2013
Last updated
11/24/2014
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