NPI 1124297775 · live from the CMS NPI Registry
Mary Lynne Hixson, RD
Dietitian, Registered in Providence, RI. National Provider Identifier 1124297775, active.
NPI record
| NPI | 1124297775 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | One Hoppin St., Coro Center, 3rd Floor, Providence, RI 02903 |
| Practice phone | 401-793-8790 |
| Mailing address | Po Box 3238, Boston, MA 02241 |
| Enumerated | February 28, 2008 |
| Last updated | March 26, 2009 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | LDN00107 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.