Provider Demographics
NPI:1396094033
Name:SCOTT, CARMELITTA MICHELLE (LPN)
Entity type:Individual
Prefix:
First Name:CARMELITTA
Middle Name:MICHELLE
Last Name:SCOTT
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 1:8982 STATE ROUTE 138
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:OH
Mailing Address - Zip Code:45728
Mailing Address - Country:US
Mailing Address - Phone:740-998-4437
Mailing Address - Fax:
Practice Address - Street 1:8982 STATE ROUTE 138
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:OH
Practice Address - Zip Code:45728
Practice Address - Country:US
Practice Address - Phone:740-998-4437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN110281164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse