Provider Demographics
NPI:1699278150
Name:GRANDO, MELISSA ANN (RN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:GRANDO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:CARMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:223 PULLEY AVE
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2246
Mailing Address - Country:US
Mailing Address - Phone:484-686-5343
Mailing Address - Fax:
Practice Address - Street 1:223 PULLEY AVE
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2246
Practice Address - Country:US
Practice Address - Phone:484-686-5343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR18450900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse