Healthcare Provider Details

I. General information

NPI: 1780279067
Provider Name (Legal Business Name): MEYBELIN SALMERON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 1ST ST APT 806
SALEM MA
01970-1879
US

IV. Provider business mailing address

800 SUMMER ST # 2
LYNN MA
01905-1930
US

V. Phone/Fax

Practice location:
  • Phone: 978-716-7971
  • Fax:
Mailing address:
  • Phone: 781-521-7953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN2315464
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: