Provider Demographics
NPI:1174045553
Name:SCOTT, MADELINE ELIZABETH
Entity type:Individual
Prefix:MS
First Name:MADELINE
Middle Name:ELIZABETH
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6884 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-2909
Mailing Address - Country:US
Mailing Address - Phone:330-402-6422
Mailing Address - Fax:
Practice Address - Street 1:6884 CHESTNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425
Practice Address - Country:US
Practice Address - Phone:330-402-6422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH373936060694Medicaid