Healthcare Provider Details

I. General information

NPI: 1730862434
Provider Name (Legal Business Name): CHELSEY MICHELLE MERLINO NDTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3429 CULPEPPER DR
SPARKS NV
89434-9215
US

IV. Provider business mailing address

3429 CULPEPPER DR
SPARKS NV
89434-9215
US

V. Phone/Fax

Practice location:
  • Phone: 177-568-6846
  • Fax:
Mailing address:
  • Phone: 177-568-6846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number86301099
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number86301099
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code136A00000X
TaxonomyRegistered Dietetic Technician
License Number86301099
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number86301099
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number86301099
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: