Provider Demographics
NPI:1942886296
Name:MILLSAPS, DEVON RAE (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:RAE
Last Name:MILLSAPS
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 GREENBRIER RIDGE WAY APT 303
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-3393
Mailing Address - Country:US
Mailing Address - Phone:865-228-4114
Mailing Address - Fax:
Practice Address - Street 1:705 GATE LN STE 202
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-3521
Practice Address - Country:US
Practice Address - Phone:865-585-2677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3508133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered