Provider Demographics
NPI:1477329746
Name:LEWIS, MELANIE (RD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 N NEVADA AVE STE 5017
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6865
Mailing Address - Country:US
Mailing Address - Phone:719-776-6810
Mailing Address - Fax:
Practice Address - Street 1:2222 N NEVADA AVE STE 5017
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6865
Practice Address - Country:US
Practice Address - Phone:719-776-6810
Practice Address - Fax:719-776-6820
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered