Provider Demographics
NPI:1427255371
Name:O'ROURKE, MEG MARIE (RD)
Entity type:Individual
Prefix:MISS
First Name:MEG
Middle Name:MARIE
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885-1906
Mailing Address - Country:US
Mailing Address - Phone:860-985-7049
Mailing Address - Fax:401-245-2009
Practice Address - Street 1:186 RHODE ISLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02724-3516
Practice Address - Country:US
Practice Address - Phone:401-245-8784
Practice Address - Fax:401-245-2009
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2100133V00000X
RI00587133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered