Provider Demographics
NPI:1225372493
Name:SCOTT, JENNIFER ANNE (CNM)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANNE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANNE
Other - Last Name:ORCUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:640 LIBERY STREET
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-9128
Mailing Address - Country:US
Mailing Address - Phone:315-759-5115
Mailing Address - Fax:315-759-5115
Practice Address - Street 1:640 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1035
Practice Address - Country:US
Practice Address - Phone:315-759-5115
Practice Address - Fax:315-759-5115
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001516176B00000X
NYF001516-1176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife