Provider Demographics
NPI:1366701252
Name:SCOTT, CHRISTY FAYE (RN, MSN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:FAYE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RN, MSN, FNP-BC
Other - Prefix:MISS
Other - First Name:CHRISTY
Other - Middle Name:FAYE
Other - Last Name:WHITEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1165 MONTGOMERY DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4801
Mailing Address - Country:US
Mailing Address - Phone:707-525-5300
Mailing Address - Fax:707-547-4637
Practice Address - Street 1:1165 MONTGOMERY DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4801
Practice Address - Country:US
Practice Address - Phone:707-525-5300
Practice Address - Fax:707-547-4637
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN470555363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily