Healthcare Provider Details

I. General information

NPI: 1649864802
Provider Name (Legal Business Name): KATELYN ANNE MELO MCKEEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2021
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 MIDDLE ST
FALL RIVER MA
02721-1733
US

IV. Provider business mailing address

795 MIDDLE ST
FALL RIVER MA
02721-1798
US

V. Phone/Fax

Practice location:
  • Phone: 508-689-3313
  • Fax:
Mailing address:
  • Phone: 508-287-3158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2281488
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: