Provider Demographics
NPI:1700569324
Name:MEDEIROS, CELINA ALEXANDRA (RN)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:ALEXANDRA
Last Name:MEDEIROS
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 1:1217 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH DIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02764-1928
Mailing Address - Country:US
Mailing Address - Phone:508-884-6262
Mailing Address - Fax:
Practice Address - Street 1:2974 E MAIN RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-4232
Practice Address - Country:US
Practice Address - Phone:401-293-5790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN73225163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient