Provider Demographics
NPI:1679593545
Name:MILLER, KRISTI (RD, LDN, CDE)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 SW CARY PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6224
Mailing Address - Country:US
Mailing Address - Phone:919-387-3200
Mailing Address - Fax:919-387-3201
Practice Address - Street 1:1515 SW CARY PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6224
Practice Address - Country:US
Practice Address - Phone:919-387-3200
Practice Address - Fax:919-387-3201
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002033133V00000X, 163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Not Answered163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2991487Medicare ID - Type Unspecified