Provider Demographics
NPI:1154032043
Name:SCOTT, HEATHER (NP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8665 S 100 W
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-4724
Mailing Address - Country:US
Mailing Address - Phone:812-350-2141
Mailing Address - Fax:
Practice Address - Street 1:8425 WOODFIELD CROSSING BLVD STE 100
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-7316
Practice Address - Country:US
Practice Address - Phone:502-244-2420
Practice Address - Fax:502-996-8282
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71013370A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner