Provider Demographics
NPI:1073544425
Name:RHOADES, MELANIE L (RD CDE)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:L
Last Name:RHOADES
Suffix:
Gender:F
Credentials:RD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:789 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2526
Mailing Address - Country:US
Mailing Address - Phone:603-742-1143
Mailing Address - Fax:603-749-3509
Practice Address - Street 1:10 MEMBERS WAY
Practice Address - Street 2:SUITE 400
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-5933
Practice Address - Country:US
Practice Address - Phone:603-742-1143
Practice Address - Fax:603-749-3509
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH210133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHMT061201Medicare PIN