Provider Demographics
NPI:1174216394
Name:SCOTT, AURORA JONQUIL (LPN)
Entity type:Individual
Prefix:
First Name:AURORA
Middle Name:JONQUIL
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 4TH ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-5327
Mailing Address - Country:US
Mailing Address - Phone:518-495-4122
Mailing Address - Fax:
Practice Address - Street 1:397 1ST ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-5303
Practice Address - Country:US
Practice Address - Phone:518-495-4122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5254860164W00000X
NY314336-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse