Provider Demographics
NPI:1851588115
Name:MUHLENBECK, MELANIE A (RD CDE)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:A
Last Name:MUHLENBECK
Suffix:
Gender:F
Credentials:RD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 S WEBSTER
Mailing Address - Street 2:SUITE 500
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301
Mailing Address - Country:US
Mailing Address - Phone:920-468-9588
Mailing Address - Fax:920-468-1342
Practice Address - Street 1:704 S WEBSTER
Practice Address - Street 2:SUITE 500
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301
Practice Address - Country:US
Practice Address - Phone:920-468-9588
Practice Address - Fax:920-468-1342
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL714381133V00000X
WI1286029133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered