Provider Demographics
NPI:1316996986
Name:SCARCE, PHYLLIS S (FNP, PNP)
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:S
Last Name:SCARCE
Suffix:
Gender:F
Credentials:FNP, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-4101
Mailing Address - Country:US
Mailing Address - Phone:434-792-0423
Mailing Address - Fax:434-791-4694
Practice Address - Street 1:117 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4101
Practice Address - Country:US
Practice Address - Phone:434-792-0423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024129895363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024129895OtherLICENSE
VA0017136772OtherAUTHORIZATION TO PRESCRIB
VA0017136772OtherAUTHORIZATION TO PRESCRIB
VA0017136772OtherAUTHORIZATION TO PRESCRIB
VA007802I92Medicare ID - Type Unspecified