| Doctor Name: | MISS MICHELE SCANLON |
| NPI Number: | 1851455687 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 1860652 |
| Business Practice Address: | 13423 Booker T Washington Hwy Hardy, VA - 241013943 |
| Business Phone Number: | 5407212014 |
| Business Fax Number: | 5407721086 |
| Mailing Address: | 13423 Booker T Washington Hwy, HARDY |
| State: | VA |
| Postal Code: | 241013943 |
| Phone Number: | 9043782448 |
| Fax Number: | |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 10/01/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 1860652 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |