Basic Information
Provider Information
NPI: 1124041397
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCOTT
FirstName: CHRISTINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4239 SE 93RD ST
Address2:  
City: BERRYTON
State: KS
PostalCode: 664099303
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2200 SW GAGE BLVD
Address2:  
City: TOPEKA
State: KS
PostalCode: 666220001
CountryCode: US
TelephoneNumber: 7853503111
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/26/2006
LastUpdateDate: 06/06/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X12157KSY Pharmacy Service ProvidersPharmacist 

No ID Information.


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