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Individual
MS. BRENDA LEE LILLARD
Active
Individual
MS. BRENDA LEE LILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHS, RD, LDN
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L001873
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
165KG
BLUE CROSS BLUE SHIELD
NC
01
—
885168
DIETETIC REGISTRATION
NC
01
—
L001873
LDN
NC
Enumeration date
02/14/2007
Last updated
12/02/2011
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