Provider Demographics
NPI:1740796440
Name:ARNOLD, MELISSA (RD, LD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:ORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:301 E COURT AVE UNIT 205
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-2008
Mailing Address - Country:US
Mailing Address - Phone:515-468-3734
Mailing Address - Fax:
Practice Address - Street 1:1725 JORDAN CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5876
Practice Address - Country:US
Practice Address - Phone:515-223-7389
Practice Address - Fax:515-559-2560
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA089064133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered