MEDICARE: HEATHER KIRCHMAN RD, LD, CNSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1598539462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER KIRCHMAN RD, LD, CNSC

Provider Business Mailing Address
First Line	:	18707 GIBBONS DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75287-4045
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1721 W PLANO PKWY STE 215
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-8600
Country	:	US
Telephone Number	:	214-228-3149
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2023
Last Update Date	:	05/24/2024

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