Provider Demographics
NPI:1710916648
Name:DIXON, MEREDITH L (RN)
Entity Type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:L
Last Name:DIXON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 WHITTIER RD
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02861-2751
Mailing Address - Country:US
Mailing Address - Phone:401-722-6182
Mailing Address - Fax:
Practice Address - Street 1:1 HOPPIN ST
Practice Address - Street 2:CORO WEST, 3RD FLOOR
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4141
Practice Address - Country:US
Practice Address - Phone:401-793-9895
Practice Address - Fax:401-793-8709
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN17496163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7628-3OtherBC & BS OF RI
RI409025OtherBLUE CHIP FOR MEDICARE
RI63-00050OtherUNITED HEALTH CARE