Provider Demographics
NPI:1124880380
Name:PHIPPS, ROBIN RUTH (RDN)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:RUTH
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:RUTH
Other - Last Name:LITHGOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:465 E KENNEBEC RD
Mailing Address - Street 2:
Mailing Address - City:MACHIAS
Mailing Address - State:ME
Mailing Address - Zip Code:04654-3533
Mailing Address - Country:US
Mailing Address - Phone:508-332-9633
Mailing Address - Fax:
Practice Address - Street 1:465 E KENNEBEC RD
Practice Address - Street 2:
Practice Address - City:MACHIAS
Practice Address - State:ME
Practice Address - Zip Code:04654-3533
Practice Address - Country:US
Practice Address - Phone:508-332-9633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDI1949133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered