Healthcare Provider Details

I. General information

NPI: 1952175218
Provider Name (Legal Business Name): KAITLYN MILLIAN MS, RD, LDN, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 17
TRANQUILITY NJ
07879-0017
US

IV. Provider business mailing address

PO BOX 17
TRANQUILITY NJ
07879-0017
US

V. Phone/Fax

Practice location:
  • Phone: 908-291-2898
  • Fax:
Mailing address:
  • Phone: 908-291-2898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: