Provider Demographics
NPI:1124075585
Name:MILLS, ELIZABETH (MS, RD, LDN)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:MS
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDN
Mailing Address - Street 1:437 W MINER ST
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-2834
Mailing Address - Country:US
Mailing Address - Phone:215-546-1231
Mailing Address - Fax:
Practice Address - Street 1:3521 SILVERSIDE RD
Practice Address - Street 2:CONCORD PLAZA QUILLEN BLDG, SUITE 2D1
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4900
Practice Address - Country:US
Practice Address - Phone:302-484-2035
Practice Address - Fax:302-482-2587
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001410133V00000X, 133N00000X, 133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education