Healthcare Provider Details

I. General information

NPI: 1144144643
Provider Name (Legal Business Name): AMBER ROSE MELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 CEDAR AVE
SWANSEA MA
02777-2015
US

IV. Provider business mailing address

15 CEDAR AVE
SWANSEA MA
02777-2015
US

V. Phone/Fax

Practice location:
  • Phone: 774-294-3315
  • Fax:
Mailing address:
  • Phone: 774-294-3315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN2383250
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: