Provider Demographics
NPI:1174875041
Name:KINSTLINGER, MELISSA (MS, RD, LDN, CDE)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:KINSTLINGER
Suffix:
Gender:F
Credentials:MS, RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 SAINT PAUL AVE
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-1851
Mailing Address - Country:US
Mailing Address - Phone:443-421-6161
Mailing Address - Fax:
Practice Address - Street 1:615 SAINT PAUL AVE
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-1851
Practice Address - Country:US
Practice Address - Phone:443-421-6161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD819256133NN1002X, 133V00000X, 133VN1004X, 133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal