Diana M. Miller, MPH, RD, LDN, CLC

Individual provider Active NPI Pediatric Nutrition Registered Dietitian · Pinehurst, NC

NPI 1700907409 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1700907409
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nutrition Registered Dietitian 133VN1004X
License
L002904 (NC)
Practice address
10 Parker LN
Suite 1
Pinehurst, NC 28374-7903
Phone
(910) 295-3133
Fax
(910) 295-2723
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
L002904NCMDPediatric Nutrition Registered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X L002904 NC Yes

Addresses

Primary practice location

10 Parker LN
Suite 1
Pinehurst, NC 28374-7903

Mailing address

306 Cross St
Sanford, NC 27330-3818
Phone (919) 776-0324

Other identifiers

IdentifierTypeStateIssuer
3403400MedicaidNC

Other providers in Pinehurst, NC

All providers in Pinehurst, NC · Pediatric Nutrition Registered Dietitian in North Carolina

Sources for this page

Verify at the official NPI Registry.