Healthcare Provider Details

I. General information

NPI: 1316423718
Provider Name (Legal Business Name): BRITTANY MILLER RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 07/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14036 BRITTON PARK RD
FISHERS IN
46038-4463
US

IV. Provider business mailing address

14036 BRITTON PARK RD
FISHERS IN
46038-4463
US

V. Phone/Fax

Practice location:
  • Phone: 317-284-1752
  • Fax:
Mailing address:
  • Phone: 317-284-1752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1108727
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: