Provider Demographics
NPI:1396250734
Name:ZAHN, MELISSA NICOLE (RD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:NICOLE
Last Name:ZAHN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:NICOLE
Other - Last Name:BIEDRON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1730 N CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-962-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37002855A133V00000X
IL164007084133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN266430700OtherMEDICARE PTAN
IN000001145630OtherANTHEM PTAN