Provider Demographics
NPI:1871133728
Name:SCOTT, MELISSA R (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:R
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 OLD EASTOVER RD
Mailing Address - Street 2:
Mailing Address - City:EASTOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29044-8303
Mailing Address - Country:US
Mailing Address - Phone:803-353-8741
Mailing Address - Fax:803-353-8789
Practice Address - Street 1:3041 OLD EASTOVER RD
Practice Address - Street 2:
Practice Address - City:EASTOVER
Practice Address - State:SC
Practice Address - Zip Code:29044-8303
Practice Address - Country:US
Practice Address - Phone:803-353-8741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23355363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily