Healthcare Provider Details

I. General information

NPI: 1396601019
Provider Name (Legal Business Name): MELISSA MCPHERSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

25 WELLS ST
WESTERLY RI
02891-2934
US

IV. Provider business mailing address

30 WILSON LN
GROTON CT
06340-2436
US

V. Phone/Fax

Practice location:
  • Phone: 401-348-3325
  • Fax:
Mailing address:
  • Phone: 860-389-5649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN49047
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: