Provider Demographics
NPI:1972093151
Name:CROWSON, MELISSA MURPHY (RDN, MS)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MURPHY
Last Name:CROWSON
Suffix:
Gender:F
Credentials:RDN, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 VILLAGE VIEW DR STE 405
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-0042
Mailing Address - Country:US
Mailing Address - Phone:803-413-6548
Mailing Address - Fax:
Practice Address - Street 1:143 VILLAGE VIEW DR STE 405
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-0042
Practice Address - Country:US
Practice Address - Phone:803-413-6548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86109417133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered