Provider Demographics
NPI:1972880565
Name:SCOTT, LYNN A (RPH)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:A
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9527 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9533
Mailing Address - Country:US
Mailing Address - Phone:414-304-1239
Mailing Address - Fax:414-304-1534
Practice Address - Street 1:9527 S 27TH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-9533
Practice Address - Country:US
Practice Address - Phone:414-304-1239
Practice Address - Fax:414-304-1534
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8563183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI8563OtherPHARMACY LIC.