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General NPI Number Information
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NPI Number | 1225564644
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Entity Type | Individual
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Provider Name | HEIDI GILLETTE RDN, LD
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Gender | Female
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 469 HIGHWAY 50
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City | GILLETTE
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State | WY
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Zip | 82718-9330
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Country | US
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Telephone | 307-387-9850
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Fax | 307-387-9890
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Provider Business Mailing Address
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Address Line | 201 W LAKEWAY RD STE 1004
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City | GILLETTE
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State | WY
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Zip | 82718-6349
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Country | US
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Telephone | 307-688-2690
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 085
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License Number State | WY
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