Provider Demographics
NPI:1306269048
Name:MELISSA A. WESNER, RD, LDN
Entity type:Organization
Organization Name:MELISSA A. WESNER, RD, LDN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WESNER
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:484-574-0235
Mailing Address - Street 1:69 FAIRFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-3610
Mailing Address - Country:US
Mailing Address - Phone:484-574-0235
Mailing Address - Fax:
Practice Address - Street 1:69 FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-3610
Practice Address - Country:US
Practice Address - Phone:484-574-0235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005025133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty