Individual
JACLYN MELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
RN2264880
MA
363L00000X
Nurse Practitioner
RN2264880
MA
363LN0000X
Neonatal Nurse Practitioner
RN2264880
MA
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
RN2264880
MA
Other
Enumeration date
10/21/2020
Last updated
12/15/2021
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