Provider Demographics
NPI:1447484449
Name:PARKER, MELINDA LEE (RD, MS, LDN)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:LEE
Last Name:PARKER
Suffix:
Gender:F
Credentials:RD, MS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9570 TOFT CT
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6129
Mailing Address - Country:US
Mailing Address - Phone:412-366-6406
Mailing Address - Fax:
Practice Address - Street 1:3380 BLVD OF THE ALLIES
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3125
Practice Address - Country:US
Practice Address - Phone:412-641-3199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA000696133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered