Provider Demographics
NPI:1710322649
Name:ANKER, MELISSA ANN (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:ANKER
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:MS
Other - First Name:MISSY
Other - Middle Name:ANN
Other - Last Name:ANKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD, LD
Mailing Address - Street 1:923 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:WINTERSET
Mailing Address - State:IA
Mailing Address - Zip Code:50273-1231
Mailing Address - Country:US
Mailing Address - Phone:515-462-4051
Mailing Address - Fax:515-462-6739
Practice Address - Street 1:923 N 1ST ST
Practice Address - Street 2:
Practice Address - City:WINTERSET
Practice Address - State:IA
Practice Address - Zip Code:50273-1231
Practice Address - Country:US
Practice Address - Phone:515-462-4051
Practice Address - Fax:515-462-6739
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002115133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered