MEDICARE: DR. DANIELLE HEARD DCN, MS,MS,CNS, LDN

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	DX4262	MD
2	133V00000X	Registered Dietitian	010713	NY
3	133N00000X	Nutritionist	ND10643	FL
4	133NN1002X	Nutrition Education Nutritionist	ND10643	FL
5	133NN1002X	Nutrition Education Nutritionist	010713	NY
6	133V00000X	Registered Dietitian	ND10643	FL
7	133N00000X	Nutritionist	DX4262	MD
8	133NN1002X	Nutrition Education Nutritionist	119388	AK
9	133N00000X	Nutritionist	119388	AK
10	133N00000X	Nutritionist	010713	NY
11	133NN1002X	Nutrition Education Nutritionist	DX4262	MD
12	133V00000X	Registered Dietitian	119388	AK

General Provider Information

NPI Number	:	1891233987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIELLE HEARD DCN, MS,MS,CNS, LDN

Provider Business Mailing Address
First Line	:	1605 GLENROSE ST
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75604-2624
Country	:	US
Telephone Number	:	903-759-0172
Fax Number	:

Provider Business Practice Location Address
First Line	:	1605 GLENROSE ST
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75604
Country	:	US
Telephone Number	:	903-759-0172
Fax Number	:

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

Provider Enumeration Date	:	02/08/2017
Last Update Date	:	10/11/2025

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