Provider Demographics
NPI:1619369238
Name:KARCH, MELISSA (RDN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:KARCH
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 DELAWARE AVE STE 303C
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-6169
Mailing Address - Country:US
Mailing Address - Phone:720-252-9415
Mailing Address - Fax:720-302-0613
Practice Address - Street 1:825 DELAWARE AVE
Practice Address - Street 2:STE 200
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6169
Practice Address - Country:US
Practice Address - Phone:720-252-9415
Practice Address - Fax:720-302-0613
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-19
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO415741OtherPTAN