Provider Demographics
NPI:1902333255
Name:SCOTT, MELISSA ANN
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 E MADISON AVE APT 19
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-3108
Mailing Address - Country:US
Mailing Address - Phone:405-436-4674
Mailing Address - Fax:
Practice Address - Street 1:229 E MADISON AVE APT 19
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-3108
Practice Address - Country:US
Practice Address - Phone:405-924-4865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program