Healthcare Provider Details

I. General information

NPI: 1861781817
Provider Name (Legal Business Name): NANCY J MILLER RD, PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2011
Last Update Date: 03/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 E LINWOOD BLVD DEPT. OF FOOD & NUTRITION
KANSAS CITY MO
64128-2226
US

IV. Provider business mailing address

4801 E LINWOOD BLVD DEPT. OF FOOD & NUTRITION
KANSAS CITY MO
64128-2226
US

V. Phone/Fax

Practice location:
  • Phone: 816-861-4700
  • Fax: 816-922-4651
Mailing address:
  • Phone: 816-861-4700
  • Fax: 816-922-4651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2008015086
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: