MEDICARE: STELLA DEDE-NOLLY RN

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	163W00000X	Registered Nurse	RN10001485	MA

General Provider Information

NPI Number	:	1194684829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STELLA DEDE-NOLLY RN

Provider Business Mailing Address
First Line	:	6 NATHAN PRATT DR UNIT 201
Second Line	:
City	:	CONCORD
State	:	MA
Zip	:	01742-4642
Country	:	US
Telephone Number	:	267-694-4143
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 NATHAN PRATT DR UNIT 201
Second Line	:	UNIT 201
City	:	CONCORD
State	:	MA
Zip	:	01742-4642
Country	:	US
Telephone Number	:	267-694-4143
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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