MEDICARE: MS. ELIZABETH MILLS MS, RD, LDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	DN001410	PA
2	133N00000X	Nutritionist	DN001410	PA
3	133NN1002X	Nutrition Education Nutritionist	DN001410	PA

General Provider Information

NPI Number	:	1124075585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH MILLS MS, RD, LDN

Provider Business Mailing Address
First Line	:	437 W MINER ST
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-2834
Country	:	US
Telephone Number	:	215-546-1231
Fax Number	:

Provider Business Practice Location Address
First Line	:	3521 SILVERSIDE RD
Second Line	:	CONCORD PLAZA QUILLEN BLDG, SUITE 2D1
City	:	WILMINGTON
State	:	DE
Zip	:	19810-4900
Country	:	US
Telephone Number	:	302-484-2035
Fax Number	:	302-482-2587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	05/02/2013

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