KAREN DEVEREAUX MELILLO (NPI# 1871101444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871101444 |
| Entity Type | Individual |
| Full Name | KAREN DEVEREAUX MELILLO |
| Practice Address |
113 Wilder St Ste 200 Lowell MA 01854-3057 |
| Mailing Address |
232 Raleigh Tavern Ln North Andover MA 01845-5632 |
| Practice Telephone | 9789344417 |
| Practice Fax Number | 9789342015 |
| Mailing Telephone | 9786833872 |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
119120 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
113 WILDER ST STE 200 |
| City | LOWELL |
| State | MA |
| Zip Code | 01854-3057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780238659 | Adeyemi Christanah Adeniyi | Nurse Practitioner | 113 Wilder St Ste 200, Lowell, MA 01854-3057 | 2019-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780224246 | Alexander C Mellin | Specialist/Technologist | Costello Athletic Center, 275 Riverside Street, Lowell, MA 01854 | 2020-01-13 |
| 1831656131 | Shaquilla U Terry | Behavior Technician | 810 Broadway St, Apt 5, Lowell, MA 01854 | 2019-02-23 |
| 1073010187 | John R Dunn | Counselor | Lowell House Inc, 555 Merrimack Street, Lowell, MA 01854 | 2018-04-06 |
| 1730604661 | Grecia Aybar | Counselor | 11 White Street, Lowell, MA 01854 | 2017-08-11 |
| 1659812550 | Krystal Demmons | Counselor | 371 Varnum Ave, Lowell, MA 01854 | 2017-03-13 |
| 1891115366 | Stacey Bourbeau | Counselor | 391 Varnum Avenue Lower Level, Lowell, MA 01854 | 2014-04-23 |
| 1013270446 | Alexandra Miniati | Internal Medicine | 275 Varnum Ave Riverside Medical Group, Ste 201, Lowell, MA 01854 | 2012-06-20 |
| 1750608923 | Elisha S Bartlett | Social Worker | 391 Varnum Avenue, Lowell, MA 01854 | 2010-04-28 |
| 1871820399 | Sandy Ann Thongkhamsouk | Counselor | 391 Varnum St., Lowell, MA 01854 | 2009-11-04 |
| 1427299007 | Kristin A. Larson | Nurse Practitioner | 220 Pawtucket St Suite 300, University Crossing, Lowell, MA 01854 | 2009-03-12 |
| Find all providers in zip 01854 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417114265 | Mary Ellen Powers | Nurse Practitioner | 45 Palmer St, Lowell, MA 01852-1834 | 2008-05-20 |
| 1285750463 | Christine Judith Anderson | Nurse Practitioner | 295 Varnum Ave, Riverside Primary Care Ipa, Lowell, MA 01854-2134 | 2007-03-21 |
| 1104981885 | Marilyn M Stelly-gendron | Nurse Practitioner | 35 Market St, Lowell, MA 01852-6245 | 2006-12-24 |
| 1720027394 | Marilyn Ann Macdonnell | Nurse Practitioner | 130 Marshall Rd, Lowell, MA 01852-5130 | 2006-06-06 |
| 1417904186 | Mary Dorothy Witkos | Nurse Practitioner | 130 Marshall Rd, Lowell, MA 01852-5130 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018370 | Ashley Erin Dimauro | Nurse Practitioner | 155 Federal St Ste 700, Boston, MA 02110-1727 | 2019-11-18 |
| 1780228924 | Jeffrey J Benoit | Nurse Practitioner | 103 Upper Rd, Deerfield, MA 01342-9739 | 2019-10-31 |
| 1962064626 | Katharine Kingsley Campbell | Nurse Practitioner | 50 Orchardhill Rd, Jamaica Plain, MA 02130-3725 | 2019-07-02 |
| 1124502737 | Rebecca Gaffney | Nurse Practitioner | 200 Mill Rd Ste 190, Fairhaven, MA 02719-5259 | 2018-09-19 |
| 1154821114 | Caroline Namuzinda Mawanda | Nurse Practitioner | 8 Baron Park Ln Apt 20, Burlington, MA 01803-5453 | 2018-02-16 |
| 1205334588 | Mary Torkornoo | Nurse Practitioner | 430 Massasoit Rd, Worcester, MA 01604-3546 | 2018-01-31 |
| 1508374406 | Kristin Tyrrell Chouinard | Nurse Practitioner | Home Md, 75 Sylvan St., Danvers, MA 01923-0192 | 2018-01-14 |
| 1962921379 | Krysta L Doucette | Nurse Practitioner | 47 High Street Suite 101, North Andover, MA 01845-5201 | 2017-09-18 |
| 1366961310 | Christine Anna Corallino | Nurse Practitioner | 14 Foster Street, #3, Boston, MA 02109 | 2017-09-11 |
| 1922546407 | Lisa Marie Joyce | Nurse Practitioner | 321 Manley St, West Bridgewater, MA 02379 | 2017-02-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.