Provider Demographics
NPI:1609236751
Name:MEHRINGER, LISA (RD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:MEHRINGER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:GAYLE
Other - Last Name:MEHRINGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, LD,
Mailing Address - Street 1:1379 GREEN ELM DR
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-3348
Mailing Address - Country:US
Mailing Address - Phone:314-749-6074
Mailing Address - Fax:
Practice Address - Street 1:1 BARNES HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-215-7375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001023322133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered