Provider Demographics
NPI:1902327760
Name:SCRUGGS, BETSEY COLLINS (NP-C)
Entity Type:Individual
Prefix:
First Name:BETSEY
Middle Name:COLLINS
Last Name:SCRUGGS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:722 HYATT ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29341-2643
Practice Address - Country:US
Practice Address - Phone:864-489-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-02
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21121363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSCA9135193OtherMEDICARE PIN
SCSCA9136067OtherMEDICARE PIN
SCSCA9136121OtherMEDICARE PIN
SCNP4593Medicaid
SCSCA913J577OtherMEDICARE PIN