Provider Demographics
NPI:1366105959
Name:LOCKHART, MELISSA LYNNE (RD, LDN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNNE
Last Name:LOCKHART
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 1:642 HOLLY PIKE
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17065
Mailing Address - Country:US
Mailing Address - Phone:717-574-0979
Mailing Address - Fax:
Practice Address - Street 1:361 ALEXANDER SPRING RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-6940
Practice Address - Country:US
Practice Address - Phone:717-960-3450
Practice Address - Fax:717-231-8853
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004120133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty