MEDICARE: MRS. SHELLEY G. MELLINO 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	163WS0200X	School Registered Nurse	RN134081	OH

General Provider Information

NPI Number	:	1912305475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHELLEY G. MELLINO RN

Provider Business Mailing Address
First Line	:	1355 W. 70TH
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102
Country	:	US
Telephone Number	:	216-281-7146
Fax Number	:	216-281-7001

Provider Business Practice Location Address
First Line	:	1355 W. 70TH
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102
Country	:	US
Telephone Number	:	216-281-7146
Fax Number	:	216-281-7001

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

Provider Enumeration Date	:	12/16/2014
Last Update Date	:	12/16/2014

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