Provider Demographics
NPI:1457125304
Name:SCOTT, JOHN SPENCER (FNP-C)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:SPENCER
Last Name:SCOTT
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18568 FORTY SIX PKWY STE 1001
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6878
Mailing Address - Country:US
Mailing Address - Phone:830-438-9300
Mailing Address - Fax:
Practice Address - Street 1:18568 FORTY SIX PKWY STE 1001
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6878
Practice Address - Country:US
Practice Address - Phone:830-438-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-10
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1151874363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily