Provider Demographics
NPI:1841063328
Name:MELLO, NICOLE (MSN, RN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:MELLO
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1693 WELLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02715-1005
Mailing Address - Country:US
Mailing Address - Phone:508-488-8500
Mailing Address - Fax:
Practice Address - Street 1:20 CENTER ST # 2
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-2270
Practice Address - Country:US
Practice Address - Phone:508-946-2408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2318382163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health