Healthcare Provider Details
I. General information
NPI: 1720849656
Provider Name (Legal Business Name): MORE SPOONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2024
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5203 JUAN TABO BLVD NE STE 2B
ALBUQUERQUE NM
87111-2691
US
IV. Provider business mailing address
PO BOX 212
WILLIAMSBURG NM
87942-0212
US
V. Phone/Fax
- Phone: 575-201-3344
- Fax: 575-334-0201
- Phone: 575-201-3344
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MELINDA
ROSE
JONES
Title or Position: OWNER/PROVIDER
Credential: RDN, PA-C
Phone: 575-201-3344