Provider Demographics
NPI:1194308239
Name:MEYERS, MELISSA (RDN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MEYERS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7333
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-0103
Mailing Address - Country:US
Mailing Address - Phone:720-447-5150
Mailing Address - Fax:
Practice Address - Street 1:8 DEBRA ANN RD
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-9762
Practice Address - Country:US
Practice Address - Phone:720-447-5150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO394227910133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered