Provider Demographics
NPI:1518494806
Name:PRIDE, HILLARY (RDN, LD, NASM-CPT)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:
Last Name:PRIDE
Suffix:
Gender:F
Credentials:RDN, LD, NASM-CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CUSHMAN ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-3772
Mailing Address - Country:US
Mailing Address - Phone:207-208-7237
Mailing Address - Fax:
Practice Address - Street 1:32 CUSHMAN ST APT 2B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3772
Practice Address - Country:US
Practice Address - Phone:207-208-7237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-17
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered