Provider Demographics
NPI:1962925677
Name:SCOTT, TASHEKA JANINE I
Entity type:Individual
Prefix:MS
First Name:TASHEKA
Middle Name:JANINE
Last Name:SCOTT
Suffix:I
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 1:629 CRENSHAW ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-1548
Mailing Address - Country:US
Mailing Address - Phone:251-391-5957
Mailing Address - Fax:
Practice Address - Street 1:629 CRENSHAW STREET
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606
Practice Address - Country:US
Practice Address - Phone:251-391-5957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty