Provider Demographics
NPI:1235391582
Name:REED, MELINDA SUE (RD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:SUE
Last Name:REED
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 1:338 S DAKOTA AVE
Mailing Address - Street 2:BLDG 13848
Mailing Address - City:VANDENBERG AFB
Mailing Address - State:CA
Mailing Address - Zip Code:93437-6307
Mailing Address - Country:US
Mailing Address - Phone:805-606-2221
Mailing Address - Fax:805-605-0978
Practice Address - Street 1:338 S DAKOTA AVE
Practice Address - Street 2:BLDG 13848
Practice Address - City:VANDENBERG AFB
Practice Address - State:CA
Practice Address - Zip Code:93437-6307
Practice Address - Country:US
Practice Address - Phone:805-606-2221
Practice Address - Fax:805-605-0978
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
871845133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
2072-0435OtherCERTIFIED DIABETES EDUCATOR
871845OtherREGISTERED DIETITAN