Provider Demographics
NPI:1306635396
Name:SCOTT, JENNIFER C (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:C
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2346 CAMDEN DR APT C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-1156
Mailing Address - Country:US
Mailing Address - Phone:443-978-9008
Mailing Address - Fax:
Practice Address - Street 1:2346 CAMDEN DR APT C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-1156
Practice Address - Country:US
Practice Address - Phone:443-978-9008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95272754163W00000X, 163WL0100X, 163WM0102X
TX1177016163WG0000X, 163WL0100X, 163WM0102X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WM0102XNursing Service ProvidersRegistered NurseMaternal NewbornGroup - Multi-Specialty