Provider Demographics
NPI:1477614683
Name:MILLAR, MARCIE ANN (RD,LDN)
Entity Type:Individual
Prefix:MS
First Name:MARCIE
Middle Name:ANN
Last Name:MILLAR
Suffix:
Gender:F
Credentials:RD,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 POINT JUDITH RD
Mailing Address - Street 2:C6
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-3451
Mailing Address - Country:US
Mailing Address - Phone:401-782-6800
Mailing Address - Fax:401-782-6886
Practice Address - Street 1:140 POINT JUDITH RD
Practice Address - Street 2:C6
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3451
Practice Address - Country:US
Practice Address - Phone:401-782-6800
Practice Address - Fax:401-782-6886
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00067133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI408887OtherBLUE CHIP
RI63-0051OtherUNITEDHEALTHCARE
RI234746-8OtherBLUE CROSS,BLUE SHIELD