Provider Demographics
NPI:1518905280
Name:MCMILLIAN, DAWN M (RD,LDN)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:M
Last Name:MCMILLIAN
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 1:106 ELDON LN
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-4704
Mailing Address - Country:US
Mailing Address - Phone:919-303-0353
Mailing Address - Fax:
Practice Address - Street 1:106 ELDON LN
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-4704
Practice Address - Country:US
Practice Address - Phone:919-303-0353
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002774133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
2994282Medicare ID - Type Unspecified