Healthcare Provider Details

I. General information

NPI: 1750256301
Provider Name (Legal Business Name): LILE NUTRITION AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5340 ANDOVER RD
WILMINGTON NC
28403-3468
US

IV. Provider business mailing address

5340 ANDOVER RD
WILMINGTON NC
28403-3468
US

V. Phone/Fax

Practice location:
  • Phone: 919-943-1268
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: ERIN LILE
Title or Position: OWNER/ CEO
Credential: MPH, RD
Phone: 919-943-1268