MEDICARE: MELISSA J TEIXEIRA R.N.

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	202255	MA

General Provider Information

NPI Number	:	1841471109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA J TEIXEIRA R.N.

Provider Business Mailing Address
First Line	:	40 OAK PT
Second Line	:
City	:	WRENTHAM
State	:	MA
Zip	:	02093-1278
Country	:	US
Telephone Number	:	508-384-7732
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 OAK PT
Second Line	:
City	:	WRENTHAM
State	:	MA
Zip	:	02093-1278
Country	:	US
Telephone Number	:	508-384-7732
Fax Number	:

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

Provider Enumeration Date	:	11/15/2007
Last Update Date	:	11/15/2007

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