Provider Demographics
NPI:1538058979
Name:MELTON, TEAGHAN GWYNN HELENA
Entity type:Individual
Prefix:
First Name:TEAGHAN
Middle Name:GWYNN HELENA
Last Name:MELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 HIBLER RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-5418
Mailing Address - Country:US
Mailing Address - Phone:973-219-8662
Mailing Address - Fax:
Practice Address - Street 1:112 HIBLER RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-5418
Practice Address - Country:US
Practice Address - Phone:973-219-8662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR222781600163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn