Provider Demographics
NPI:1518382571
Name:SCOLA, MICHELLE SALVATO (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:SALVATO
Last Name:SCOLA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:SALVATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:275 VARNUM AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2141
Mailing Address - Country:US
Mailing Address - Phone:978-452-9700
Mailing Address - Fax:978-441-6075
Practice Address - Street 1:275 VARNUM AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2141
Practice Address - Country:US
Practice Address - Phone:978-452-9700
Practice Address - Fax:978-441-6075
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2261470363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily