Individual
NICOLE LYN SCOURAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
85 HIGH ST, MEDFORD, MA 02155-3825
(781) 396-4770
Mailing address
85 HIGH ST, MEDFORD, MA 02155-3825
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
21340
CA
363LF0000X
Family Nurse Practitioner
806756
CA
363LF0000X
Family Nurse Practitioner
Primary
RN2264342
MA
Other
Enumeration date
10/04/2011
Last updated
04/15/2021
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