MEDICARE: ELIZABETH KAREN SCAMMON FNP-BC

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
1	363L00000X	Nurse Practitioner	RN2331620	MA
2	163W00000X	Registered Nurse	RN2331620	MA

General Provider Information

NPI Number	:	1053068122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH KAREN SCAMMON FNP-BC

Provider Business Mailing Address
First Line	:	380R MERRIMACK ST
Second Line	:
City	:	METHUEN
State	:	MA
Zip	:	01844-5883
Country	:	US
Telephone Number	:	978-685-5627
Fax Number	:

Provider Business Practice Location Address
First Line	:	380R MERRIMACK ST
Second Line	:
City	:	METHUEN
State	:	MA
Zip	:	01844-5883
Country	:	US
Telephone Number	:	978-685-5627
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2022
Last Update Date	:	03/09/2026

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