Provider Demographics
NPI:1275043101
Name:MILLER, TRACY-LEE (MS, RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:TRACY-LEE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 HALLWORTH DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7315
Mailing Address - Country:US
Mailing Address - Phone:401-487-9776
Mailing Address - Fax:401-737-2706
Practice Address - Street 1:198 HALLWORTH DR
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7315
Practice Address - Country:US
Practice Address - Phone:401-487-9776
Practice Address - Fax:401-737-2706
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI000924133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered