Provider Demographics
NPI:1487943460
Name:SCOTT, TIA (WHNP-BC, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TIA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:WHNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 SPRING MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-8964
Mailing Address - Country:US
Mailing Address - Phone:901-355-9153
Mailing Address - Fax:
Practice Address - Street 1:1264 WESLEY DR STE 402
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-6447
Practice Address - Country:US
Practice Address - Phone:901-396-5577
Practice Address - Fax:901-396-6538
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN184461363LW0102X
TNRN0000155509363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health