NPI 1235538802 · live from the CMS NPI Registry
Melissa Marie Wallinga, DCN, RD, LD
Dietitian, Registered, Nutrition, Pediatric in Meridian, ID. National Provider Identifier 1235538802, active.
NPI record
| NPI | 1235538802 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered, Nutrition, Pediatric 133VN1004X |
| Practice location | 4272 E Westport Ct, Meridian, ID 83642 |
| Practice phone | 712-540-3072 |
| Mailing address | 1603 Capitol Ave Ste 411f, Cheyenne, WY 82001 |
| Enumerated | August 19, 2014 |
| Last updated | May 19, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered, Nutrition, Pediatric primary | 133VN1004X | D-827 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.