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General NPI Number Information
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NPI Number | 1598614950
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Entity Type | Individual
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Provider Name | JESSICA MEILEY
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Gender | Female
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 399 REVOLUTION DR
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City | SOMERVILLE
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State | MA
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Zip | 02145-1484
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Country | US
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Telephone | 800-833-3515
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Fax |
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Provider Business Mailing Address
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Address Line | 32 WINCHESTER ST APT 3
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City | BROOKLINE
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State | MA
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Zip | 02446-2858
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Country | US
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Telephone | 845-325-5818
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | ATL2058
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License Number State | MA
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