Provider Demographics
NPI:1023673209
Name:BARLOW, SCOTT ROBERT (DNP)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ROBERT
Last Name:BARLOW
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 E CHUBBUCK RD
Mailing Address - Street 2:
Mailing Address - City:CHUBBUCK
Mailing Address - State:ID
Mailing Address - Zip Code:83202-1816
Mailing Address - Country:US
Mailing Address - Phone:208-233-9898
Mailing Address - Fax:208-232-8566
Practice Address - Street 1:476 E CHUBBUCK RD
Practice Address - Street 2:
Practice Address - City:CHUBBUCK
Practice Address - State:ID
Practice Address - Zip Code:83202-1816
Practice Address - Country:US
Practice Address - Phone:208-233-9898
Practice Address - Fax:208-232-8566
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60981194363L00000X
WAAP60981196363L00000X
ID61628363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner