Provider Demographics
NPI:1043359557
Name:SCOTT, JULIANNE BAKER (MS, NP)
Entity type:Individual
Prefix:MS
First Name:JULIANNE
Middle Name:BAKER
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS, NP
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 565
Mailing Address - Street 2:840 KENWOOD AVENUE
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-0565
Mailing Address - Country:US
Mailing Address - Phone:518-478-0833
Mailing Address - Fax:
Practice Address - Street 1:840 KENWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-0565
Practice Address - Country:US
Practice Address - Phone:518-478-0833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400401-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner