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ELIZABETH B REVILLA MS RD LD CSP NPI 1265631436


NPI Information

NPI: 1265631436
Provider Name: ELIZABETH B REVILLA, MS, RD, LD, CSP
Classification: Dietitian, Registered - 133VN1004X
Entity Type: Individual

Specialization: Nutrition, Pediatric

Address:
1547 CLIFTON RD NE
ATLANTA, GA
ZIP 30322
Phone: (404) 785-1784
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Elizabeth B Revilla, MS, RD, LD, CSP is a nutrition and pediatric dietitian registered in Atlanta, GA. The provider is an individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn up to 21 years of age) as well as children with special health care needs in a variety of settings (hospitals, community-based and/or family-centered programs, education programs, home, etc.), OR indirectly through management, care coordination, education, quality improvement, or research practice linked specifically to pediatric nutrition. Elizabeth B Revilla, MS, RD, LD, CSP NPI is 1265631436. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1547 CLIFTON RD NE
ATLANTA, GA
ZIP 30322-008
Phone: (404) 785-1784
Fax: (404) 727-4828

The enumeration date for this NPI number is 7/17/2007 and was last updated on 7/17/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1133VN1004XDietitian, RegisteredNutrition, PediatricLD002723GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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