Provider Demographics
NPI:1730619420
Name:NOWLAND, MELISSA JOY (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:JOY
Last Name:NOWLAND
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 CHARLOTTE PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3320
Mailing Address - Country:US
Mailing Address - Phone:615-222-1900
Mailing Address - Fax:
Practice Address - Street 1:4928 EDMONDSON PIKE STE 205
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211
Practice Address - Country:US
Practice Address - Phone:615-222-1400
Practice Address - Fax:615-222-1410
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1894133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNINPROCESSOtherTN MEDICARE
TNINPROCESSMedicaid