Provider Demographics
NPI:1659435402
Name:MILLER, BRYN ELIZABETH (RD)
Entity Type:Individual
Prefix:MRS
First Name:BRYN
Middle Name:ELIZABETH
Last Name:MILLER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 DALE RD
Mailing Address - Street 2:KAISER PERMANENTE HEALTH EDUCATION
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-8627
Mailing Address - Country:US
Mailing Address - Phone:209-557-6585
Mailing Address - Fax:209-667-6025
Practice Address - Street 1:3800 DALE RD
Practice Address - Street 2:HEALTH EDUCATION
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-8627
Practice Address - Country:US
Practice Address - Phone:209-557-6585
Practice Address - Fax:209-557-6025
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered