Provider Demographics
NPI:1790472546
Name:PEREIRA, MELANIE DENISE (RN2289554)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:DENISE
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:RN2289554
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1188 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:MA
Mailing Address - Zip Code:02726-5140
Mailing Address - Country:US
Mailing Address - Phone:508-281-1064
Mailing Address - Fax:
Practice Address - Street 1:1188 COUNTY ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:MA
Practice Address - Zip Code:02726-5140
Practice Address - Country:US
Practice Address - Phone:508-281-1064
Practice Address - Fax:508-281-4013
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2289554363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health