Provider Demographics
NPI:1154525459
Name:MILLER, LOIS ELAINE (RD LDN CDE)
Entity type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:ELAINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:RD LDN CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 GOLD ST
Mailing Address - Street 2:
Mailing Address - City:SHILLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19607-1120
Mailing Address - Country:US
Mailing Address - Phone:610-775-9702
Mailing Address - Fax:610-705-5633
Practice Address - Street 1:110 GOLD ST
Practice Address - Street 2:
Practice Address - City:SHILLINGTON
Practice Address - State:PA
Practice Address - Zip Code:19607-1120
Practice Address - Country:US
Practice Address - Phone:610-775-9702
Practice Address - Fax:610-705-5633
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000141133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered