Healthcare Provider Details

I. General information

NPI: 1740172147
Provider Name (Legal Business Name): HILLTOP NUTRITION CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 HILLTOP RD
ERIE PA
16509-2323
US

IV. Provider business mailing address

3411 PEACH ST UNIT 334
ERIE PA
16508-2739
US

V. Phone/Fax

Practice location:
  • Phone: 814-853-5851
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1101X
TaxonomyGerontological Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: THADDEUS GIBLIN
Title or Position: PRESIDENT
Credential:
Phone: 814-853-5851