Provider Demographics
NPI:1154335347
Name:SCOTT, SETON ANN (RN, ANP)
Entity type:Individual
Prefix:
First Name:SETON
Middle Name:ANN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RN, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 BLVD.
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07046
Mailing Address - Country:US
Mailing Address - Phone:973-334-7700
Mailing Address - Fax:973-263-5225
Practice Address - Street 1:415 BLVD.
Practice Address - Street 2:
Practice Address - City:MOUNTAIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046
Practice Address - Country:US
Practice Address - Phone:973-334-7700
Practice Address - Fax:973-263-5225
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR09167600363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7840306Medicaid
NJ548567Medicare UPIN
NJ005734Medicare ID - Type Unspecified