Provider Demographics
NPI:1942470943
Name:CHURCHILL, EMILY (RD, LD, DE)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:CHURCHILL
Suffix:
Gender:F
Credentials:RD, LD, DE
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:BERNHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:12 SCHOOL ST APT 3
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2839
Mailing Address - Country:US
Mailing Address - Phone:978-760-0472
Mailing Address - Fax:
Practice Address - Street 1:881 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-1242
Practice Address - Country:US
Practice Address - Phone:603-926-9131
Practice Address - Fax:603-926-9132
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0496133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered