MEDICARE: MS. MELISSA JEANNETTE BEARD RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0200X	Pediatric Registered Nurse	269373	MA

General Provider Information

NPI Number	:	1891914420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELISSA JEANNETTE BEARD RN

Provider Business Mailing Address
First Line	:	55 WILDERNESS WAY
Second Line	:
City	:	EAST TAUNTON
State	:	MA
Zip	:	02718-1538
Country	:	US
Telephone Number	:	774-259-7054
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 WILDERNESS WAY
Second Line	:
City	:	EAST TAUNTON
State	:	MA
Zip	:	02718-1538
Country	:	US
Telephone Number	:	774-259-7054
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	07/08/2007

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