Healthcare Provider Details

I. General information

NPI: 1851213060
Provider Name (Legal Business Name): HEIDI MARIE STIMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1983 W 5400 N
BENSON UT
84335-6704
US

IV. Provider business mailing address

1983 W 5400 N
BENSON UT
84335-6704
US

V. Phone/Fax

Practice location:
  • Phone: 435-512-0885
  • Fax:
Mailing address:
  • Phone: 435-512-0885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number18995
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: