Provider Demographics
NPI:1518552074
Name:MONTEIRO, BIANCA JULISSA (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:JULISSA
Last Name:MONTEIRO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 KIMBERLEY DR
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-2219
Mailing Address - Country:US
Mailing Address - Phone:508-649-6144
Mailing Address - Fax:
Practice Address - Street 1:12 KIMBERLEY DR
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-2219
Practice Address - Country:US
Practice Address - Phone:508-649-6144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-06
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN64457163W00000X
NY779957163W00000X
MARN2334572163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse