Provider Demographics
NPI:1316423718
Name:MILLER, BRITTANY (RDN)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14036 BRITTON PARK RD
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-4463
Mailing Address - Country:US
Mailing Address - Phone:317-284-1752
Mailing Address - Fax:
Practice Address - Street 1:14036 BRITTON PARK RD
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-4463
Practice Address - Country:US
Practice Address - Phone:317-284-1752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1108727133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered