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General NPI Number Information
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NPI Number | 1043870173
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Entity Type | Individual
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Provider Name | MARY A HIEBERT RDN, LD
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Gender | Female
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Dates
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Enumeration Date | 06/20/2019
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Last Update Date | 06/20/2019
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Provider Practice Location Address
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Address Line | 271 W 3RD ST N STE 500
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City | WICHITA
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State | KS
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Zip | 67202-1223
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Country | US
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Telephone | 316-660-5141
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Fax | 316-660-1936
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Provider Business Mailing Address
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Address Line | 1313 N MAIZE CT APT 1906
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City | WICHITA
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State | KS
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Zip | 67212-4396
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Country | US
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Telephone | 316-616-4937
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 0660
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 0660
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License Number State | KS
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