Healthcare Provider Details

I. General information

NPI: 1548463128
Provider Name (Legal Business Name): PAULA MILLER MS, RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 N OLD US HIGHWAY 81
HESSTON KS
67062-9406
US

IV. Provider business mailing address

109 E PINE ST
HESSTON KS
67062-9055
US

V. Phone/Fax

Practice location:
  • Phone: 316-217-2984
  • Fax: 620-869-9032
Mailing address:
  • Phone: 316-217-2984
  • Fax: 620-654-7530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1370
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: