Healthcare Provider Details

I. General information

NPI: 1518340710
Provider Name (Legal Business Name): MELANIE MOYERS MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 08/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5951 NATURE LN
KNOXVILLE TN
37912
US

IV. Provider business mailing address

5951 NATURE LN
KNOXVILLE TN
37912-2115
US

V. Phone/Fax

Practice location:
  • Phone: 865-567-8512
  • Fax:
Mailing address:
  • Phone: 865-567-8512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number881050
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: