Provider Demographics
NPI:1447715123
Name:SCOTT, TIERRA VERONA (CNA)
Entity type:Individual
Prefix:MS
First Name:TIERRA
Middle Name:VERONA
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 E SILVER SPRINGS BLVD STE 127
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-6833
Mailing Address - Country:US
Mailing Address - Phone:352-355-2121
Mailing Address - Fax:
Practice Address - Street 1:1515 E SILVER SPRINGS BLVD STE 127
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6833
Practice Address - Country:US
Practice Address - Phone:352-361-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30212442251E00000X
FL312172261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251E00000XAgenciesHome Health