Provider Demographics
NPI:1902128408
Name:ADAMS, TILUSHA S (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:TILUSHA
Middle Name:S
Last Name:ADAMS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 WHITE CHAPEL WAY
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-4774
Mailing Address - Country:US
Mailing Address - Phone:336-509-3079
Mailing Address - Fax:
Practice Address - Street 1:4002 WHITE CHAPEL WAY
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4774
Practice Address - Country:US
Practice Address - Phone:336-509-3079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002361133V00000X, 133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal