Provider Demographics
NPI:1427527704
Name:SCOTT, RICHARD SHERVINGTON (RN, PHN)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:SHERVINGTON
Last Name:SCOTT
Suffix:
Gender:M
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-2102
Mailing Address - Country:US
Mailing Address - Phone:952-361-1320
Mailing Address - Fax:
Practice Address - Street 1:600 E 4TH ST
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-2102
Practice Address - Country:US
Practice Address - Phone:952-361-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN991067163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health