Healthcare Provider Details

I. General information

NPI: 1710916648
Provider Name (Legal Business Name): MEREDITH L. DIXON R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOPPIN ST CORO WEST, 3RD FLOOR
PROVIDENCE RI
02903-4141
US

IV. Provider business mailing address

167 WHITTIER RD
PAWTUCKET RI
02861-2751
US

V. Phone/Fax

Practice location:
  • Phone: 401-793-9895
  • Fax: 401-793-8709
Mailing address:
  • Phone: 401-722-6182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN17496
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: