Provider Demographics
NPI:1770748824
Name:MILLS, MARCIA ANN (RD, LDN)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:ANN
Last Name:MILLS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CLOISTER CT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2295
Mailing Address - Country:US
Mailing Address - Phone:919-967-9400
Mailing Address - Fax:919-408-0643
Practice Address - Street 1:111 CLOISTER CT
Practice Address - Street 2:SUITE 212
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2295
Practice Address - Country:US
Practice Address - Phone:919-967-9400
Practice Address - Fax:919-408-0643
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000035133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCL000035OtherLDN NUMBER
NC00374981OtherRD NUMBER