Individual
BONITA LILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2121 EISENHOWER AVE, SUITE 200, ALEXANDRIA, VA 22314-4698
(703) 519-0901
(703) 519-0902
Mailing address
5412 CASTLE BAR LN, ALEXANDRIA, VA 22315-5519
(703) 879-5160
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2004009119
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G02785D01
MEDICARE PTAN
—
Enumeration date
01/11/2008
Last updated
09/18/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us