Healthcare Provider Details

I. General information

NPI: 1427984335
Provider Name (Legal Business Name): HEATHER LEIGH BURGESS RVT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER LEIGH HOTCHKIN RVT

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 6TH ST
GARDNER ND
58036-4008
US

IV. Provider business mailing address

264 6TH ST
GARDNER ND
58036-4008
US

V. Phone/Fax

Practice location:
  • Phone: 605-214-3829
  • Fax:
Mailing address:
  • Phone: 605-214-3829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number1417
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: