Provider Demographics
NPI:1730629387
Name:SCOTT, SHAUNTEL (NP)
Entity type:Individual
Prefix:
First Name:SHAUNTEL
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1609
Mailing Address - Country:US
Mailing Address - Phone:866-448-7716
Mailing Address - Fax:954-596-4746
Practice Address - Street 1:3129 KINGSLEY DR STE 1010
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8509
Practice Address - Country:US
Practice Address - Phone:832-304-4665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-01
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131833363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily