| Doctor Name: | MR. NATHAN WADE SCOTT |
| NPI Number: | 1174868095 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | A.P.R.N. |
| License Number: | 005125 |
| Business Practice Address: | 154 Main St Old Saybrook, CT - 064752373 |
| Business Phone Number: | 8603951212 |
| Business Fax Number: | 8603588654 |
| Mailing Address: | 28 Crescent St, MIDDLETOWN |
| State: | CT |
| Postal Code: | 064573654 |
| Phone Number: | 8603584820 |
| Fax Number: | 8603586748 |
| NPI Enumeration Date: | 12/04/2012 |
| NPI Last Update Date: | 12/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 005125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |