Individual provider Active NPI

Misselly Mercedes Grullon de Martinez

  • Registered Nurse
  • Lynn, MA
National Provider Identifier
1922907575
Registry record updated Nov 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN2284671 Issued in MA
Practice address
235 Woodland N
Lynn, MA 01904-1414
Phone
(781) 715-6692
NPI assigned
Nov 2, 2026
Last updated
Nov 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2284671 MA Primary

Addresses

Primary practice location

235 Woodland N
Lynn, MA 01904-1414

Mailing address

235 Woodland N
Lynn, MA 01904-1414
Phone (781) 715-6673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1793577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793577600000",
    "number": "1922907575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 WOODLAND N",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019041414",
            "telephone_number": "781-715-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WOODLAND N",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019041414",
            "telephone_number": "781-715-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRULLON DE MARTINEZ",
        "first_name": "MISSELLY",
        "middle_name": "MERCEDES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-11-02",
        "last_updated": "2026-11-02",
        "certification_date": "2026-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2284671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.