Individual
RACHEL LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
593 EDDY ST, CLAVERICK 2, PROVIDENCE, RI 02903-4923
(401) 519-1604
(401) 272-0538
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2500
(401) 854-2519
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
NPP37204
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-14-2010
NHPRI
RI
05
—
0321362
—
MA
01
—
04-15-2009
UNITED HEALTHCARE
RI
01
—
1669582144
NPI
RI
05
—
7010335
—
RI
01
—
939025129
MEDICARE GROUP NUMBER
RI
Enumeration date
08/30/2006
Last updated
08/30/2011
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