Ms Nikki Halipilias, | |
1412 Milstead Ave Ne, Conyers, GA 30012-3877 | |
(404) 274-4414 | |
Not Available |
Full Name | Ms Nikki Halipilias |
---|---|
Gender | Female |
Speciality | Dietitian, Registered |
Location | 1412 Milstead Ave Ne, Conyers, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578151247 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | LD002874 (Georgia) | Primary |
Provider Name | Moderation Is The Key |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1871357459 PECOS PAC ID: 4486094620 Enrollment ID: O20240503003356 |
Mailing Address | Practice Location Address |
---|---|
Ms Nikki Halipilias, 1412 Milstead Ave Ne, Conyers, GA 30012-3877 Ph: (404) 274-4414 | Ms Nikki Halipilias, 1412 Milstead Ave Ne, Conyers, GA 30012-3877 Ph: (404) 274-4414 |
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