Provider Demographics
NPI:1518111327
Name:RICKMEYER, MELISSA MARIE (RDN, LDN, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MARIE
Last Name:RICKMEYER
Suffix:
Gender:F
Credentials:RDN, LDN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14208 BARRINGTON STOWERS DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-4140
Mailing Address - Country:US
Mailing Address - Phone:912-660-4052
Mailing Address - Fax:
Practice Address - Street 1:14208 BARRINGTON STOWERS DR
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-4140
Practice Address - Country:US
Practice Address - Phone:912-660-4052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
GALD003128133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered