Provider Demographics
NPI:1689710667
Name:MELLO, NORMA (RN, BS, CDE, CPT)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:MELLO
Suffix:
Gender:F
Credentials:RN, BS, CDE, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NORTHWOODS MEDICAL CENTER
Mailing Address - Street 2:2005 BAY STREET, SUITE 204B
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780
Mailing Address - Country:US
Mailing Address - Phone:508-821-9400
Mailing Address - Fax:508-821-9151
Practice Address - Street 1:NORTHWOODS MEDICAL CENTER
Practice Address - Street 2:2005 BAY STREET, SUITE 204B
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780
Practice Address - Country:US
Practice Address - Phone:508-821-9400
Practice Address - Fax:508-821-9151
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA105768163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator