Individual
SHANNON L SCOLARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
235 N PEARL ST, BROCKTON, MA 02301-1794
(508) 427-3000
Mailing address
960 MASSACHUSETTS AVE STE 2, BOSTON, MA 02118-2690
(617) 414-4505
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
212661
MA
363LA2200X
Adult Health Nurse Practitioner
212661
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0391841
—
MA
01
—
39159
HARVARD PILGRIM
MA
01
—
NP2812
BLUE CROSS
MA
Enumeration date
03/29/2006
Last updated
03/17/2025
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