Provider Demographics
NPI:1851253785
Name:PHILLIPS, ALEXANDRA (MPH, RD, LDN)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MPH, RD, LDN
Other - Prefix:
Other - First Name:ALLEY
Other - Middle Name:
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:625 S ELLIOTT RD APT 304
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-2629
Mailing Address - Country:US
Mailing Address - Phone:774-571-7197
Mailing Address - Fax:
Practice Address - Street 1:625 S ELLIOTT RD APT 304
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-2629
Practice Address - Country:US
Practice Address - Phone:774-571-7197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL008961133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered