Provider Demographics
NPI:1538021035
Name:JONES, MELODYANN OBERLE
Entity type:Individual
Prefix:
First Name:MELODYANN
Middle Name:OBERLE
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1644 E ARROWHEAD LN
Mailing Address - Street 2:
Mailing Address - City:ERDA
Mailing Address - State:UT
Mailing Address - Zip Code:84074-5005
Mailing Address - Country:US
Mailing Address - Phone:801-557-9858
Mailing Address - Fax:
Practice Address - Street 1:1644 E ARROWHEAD LN
Practice Address - Street 2:
Practice Address - City:ERDA
Practice Address - State:UT
Practice Address - Zip Code:84074-5005
Practice Address - Country:US
Practice Address - Phone:801-557-9858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12451683-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered