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NPI Code Detail

MEDICARE: ELIZABETH MARIE SCAMPERLE PMHNP

MEDICARE: ELIZABETH MARIE SCAMPERLE PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerRN209754MA

General Provider Information

NPI Number : 1659994234
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MARIE SCAMPERLE PMHNP
Provider Business Mailing Address
First Line : 1501 WASHINGTON ST FL 2
Second Line :
City : BRAINTREE
State : MA
Zip : 02184-7599
Country : US
Telephone Number : 617-847-1909
Fax Number : 781-843-2418
Provider Business Practice Location Address
First Line : 1501 WASHINGTON ST FL 2
Second Line :
City : BRAINTREE
State : MA
Zip : 02184-7599
Country : US
Telephone Number : 617-847-1909
Fax Number : 781-843-2418
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2020
Last Update Date : 04/01/2023

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