Healthcare Provider Details

I. General information

NPI: 1689070856
Provider Name (Legal Business Name): MELINDA HELLER RD, LMNT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2014
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N 27TH ST
NORFOLK NE
68701-4401
US

IV. Provider business mailing address

2700 W NORFOLK AVE NUTRITION SERVICES
NORFOLK NE
68701-4438
US

V. Phone/Fax

Practice location:
  • Phone: 402-844-8126
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1148
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number1148
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: