Provider Demographics
NPI:1205384427
Name:SILLS, ERIN MARIE L (RD, LD)
Entity Type:Individual
Prefix:
First Name:ERIN MARIE
Middle Name:L
Last Name:SILLS
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 1:449 MANITOBA LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-4828
Mailing Address - Country:US
Mailing Address - Phone:859-327-2549
Mailing Address - Fax:
Practice Address - Street 1:449 MANITOBA LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40515-4828
Practice Address - Country:US
Practice Address - Phone:859-327-2549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY123604133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered