Provider Demographics
NPI:1740685064
Name:HINKLE, MELINDA (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:
Last Name:HINKLE
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 SAINT JOSEPH LN
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-8345
Mailing Address - Country:US
Mailing Address - Phone:606-330-6868
Mailing Address - Fax:606-330-6026
Practice Address - Street 1:1001 SAINT JOSEPH LN
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-8345
Practice Address - Country:US
Practice Address - Phone:606-330-6868
Practice Address - Fax:606-330-6026
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1974133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered