Healthcare Provider Details

I. General information

NPI: 1992914808
Provider Name (Legal Business Name): LUCILLE BESS MEHRING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 10/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST POTTER 2
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

593 EDDY ST POTTER 2
PROVIDENCE RI
02903-4923
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-2128
  • Fax: 401-444-8836
Mailing address:
  • Phone: 401-444-2128
  • Fax: 401-444-8836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number246453
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number37754
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number13510
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: