Provider Demographics
NPI:1891914420
Name:BEARD, MELISSA JEANNETTE (RN)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:JEANNETTE
Last Name:BEARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WILDERNESS WAY
Mailing Address - Street 2:
Mailing Address - City:EAST TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02718-1538
Mailing Address - Country:US
Mailing Address - Phone:774-259-7054
Mailing Address - Fax:
Practice Address - Street 1:55 WILDERNESS WAY
Practice Address - Street 2:
Practice Address - City:EAST TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02718-1538
Practice Address - Country:US
Practice Address - Phone:774-259-7054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA269373163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics