Provider Demographics
NPI:1912694027
Name:SHAFRANEK, MELANIE (FNTP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:SHAFRANEK
Suffix:
Gender:F
Credentials:FNTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 N CLINTON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-3625
Mailing Address - Country:US
Mailing Address - Phone:214-500-2636
Mailing Address - Fax:
Practice Address - Street 1:634 N CLINTON AVE APT 1
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-3625
Practice Address - Country:US
Practice Address - Phone:214-500-2636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist