Provider Demographics
NPI:1528687720
Name:SCOTT, MARINA FAYE (BSN)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:FAYE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11670 JEFFERIES HWY
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-5758
Mailing Address - Country:US
Mailing Address - Phone:843-908-0225
Mailing Address - Fax:
Practice Address - Street 1:22 KLEIN ST
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-3973
Practice Address - Country:US
Practice Address - Phone:843-549-5742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC00066444163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health