Provider Demographics
NPI:1821642240
Name:HILLER, JAIME L (RD, LDN, CDOE, CVDOE)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:L
Last Name:HILLER
Suffix:
Gender:F
Credentials:RD, LDN, CDOE, CVDOE
Other - Prefix:MISS
Other - First Name:JAIME
Other - Middle Name:L
Other - Last Name:NIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:54 DALE AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-5509
Mailing Address - Country:US
Mailing Address - Phone:401-573-0369
Mailing Address - Fax:
Practice Address - Street 1:54 DALE AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-5509
Practice Address - Country:US
Practice Address - Phone:401-573-0369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00829133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered