Provider Demographics
NPI:1225761141
Name:BURNS, RILEY WILLIAMS (RDN)
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:WILLIAMS
Last Name:BURNS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6928
Mailing Address - Country:US
Mailing Address - Phone:607-483-3673
Mailing Address - Fax:
Practice Address - Street 1:3240 BURNT MILL DR STE 1
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2570
Practice Address - Country:US
Practice Address - Phone:607-483-6733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered