Provider Demographics
NPI:1053679506
Name:SAVAGE, HILLARY ANN (RD, LD)
Entity Type:Individual
Prefix:MS
First Name:HILLARY
Middle Name:ANN
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 58TH ST S
Mailing Address - Street 2:APT 305
Mailing Address - City:GULFPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33707-6029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3205 58TH ST S
Practice Address - Street 2:APT 305
Practice Address - City:GULFPORT
Practice Address - State:FL
Practice Address - Zip Code:33707-6029
Practice Address - Country:US
Practice Address - Phone:727-744-7138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4732133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered