Provider Demographics
NPI:1114594942
Name:SCOGGINS, CHRISTY L (LPN)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:L
Last Name:SCOGGINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 N MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47240-7017
Mailing Address - Country:US
Mailing Address - Phone:812-527-2222
Mailing Address - Fax:812-527-2074
Practice Address - Street 1:2320 N MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-7017
Practice Address - Country:US
Practice Address - Phone:812-527-2222
Practice Address - Fax:812-527-2074
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27056312A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse