Provider Demographics
NPI:1962236661
Name:SCOTT, JOANNA C
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:C
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 1:113 HIGHLAND POINT CV
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6202
Mailing Address - Country:US
Mailing Address - Phone:501-454-4666
Mailing Address - Fax:
Practice Address - Street 1:113 HIGHLAND POINT CV
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6202
Practice Address - Country:US
Practice Address - Phone:501-454-4666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAYJ27P343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)