Healthcare Provider Details

I. General information

NPI: 1689710667
Provider Name (Legal Business Name): NORMA MELLO RN, BS, CDE, CPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NORTHWOODS MEDICAL CENTER 2005 BAY STREET, SUITE 204B
TAUNTON MA
02780
US

IV. Provider business mailing address

NORTHWOODS MEDICAL CENTER 2005 BAY STREET, SUITE 204B
TAUNTON MA
02780
US

V. Phone/Fax

Practice location:
  • Phone: 508-821-9400
  • Fax: 508-821-9151
Mailing address:
  • Phone: 508-821-9400
  • Fax: 508-821-9151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number105768
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: