Healthcare Provider Details

I. General information

NPI: 1518905280
Provider Name (Legal Business Name): DAWN M MCMILLIAN RD,LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 ELDON LN
APEX NC
27502-4704
US

IV. Provider business mailing address

106 ELDON LN
APEX NC
27502-4704
US

V. Phone/Fax

Practice location:
  • Phone: 919-303-0353
  • Fax:
Mailing address:
  • Phone: 919-303-0353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL002774
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: