Provider Demographics
NPI:1487173571
Name:MCLAUGHLIN, MELISSA (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 HODGE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-9226
Mailing Address - Country:US
Mailing Address - Phone:641-521-9035
Mailing Address - Fax:
Practice Address - Street 1:3600 HIGHWAY 151
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302
Practice Address - Country:US
Practice Address - Phone:319-377-4803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA088775133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered