Provider Demographics
NPI:1316242480
Name:SCOTT, PARDELLA JOLANDA (FNP)
Entity type:Individual
Prefix:MRS
First Name:PARDELLA
Middle Name:JOLANDA
Last Name:SCOTT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 E MOSHOLU PKWY S
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-1174
Mailing Address - Country:US
Mailing Address - Phone:718-367-6100
Mailing Address - Fax:718-733-4020
Practice Address - Street 1:176 E MOSHOLU PKWY S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-1174
Practice Address - Country:US
Practice Address - Phone:718-367-6100
Practice Address - Fax:718-733-4020
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336210-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily