Individual
MARY D. LAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNP
Contact information
Practice address
20 SOUTHWEST AVE, JAMESTOWN, RI 02835-1120
(401) 423-2616
(401) 423-3485
Mailing address
117 ELLENFIELD ST, SUITE 101, PROVIDENCE, RI 02905-4513
(401) 444-4318
(401) 444-6573
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NPP20913
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23638-6
RI BC/BS
RI
01
—
409407
RI BLUE CHIP
RI
05
—
ML42620
—
RI
Enumeration date
07/01/2005
Last updated
04/29/2015
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