Provider Demographics
NPI:1497553713
Name:MILLS, MADELINE CHRISTINE (MS, RDN, CPT)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:CHRISTINE
Last Name:MILLS
Suffix:
Gender:F
Credentials:MS, RDN, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 1ST AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2904
Mailing Address - Country:US
Mailing Address - Phone:630-842-9051
Mailing Address - Fax:
Practice Address - Street 1:123 1ST AVE APT 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2904
Practice Address - Country:US
Practice Address - Phone:630-842-9051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86372351133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered