Provider Demographics
NPI:1114349891
Name:CUNNINGHAM, HEIKI DANIELLE (RDN)
Entity Type:Individual
Prefix:MRS
First Name:HEIKI
Middle Name:DANIELLE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1634 SPRINGWIND DR SW
Mailing Address - Street 2:
Mailing Address - City:BYRON CENTER
Mailing Address - State:MI
Mailing Address - Zip Code:49315-7928
Mailing Address - Country:US
Mailing Address - Phone:616-914-6148
Mailing Address - Fax:
Practice Address - Street 1:1634 SPRINGWIND DR SW
Practice Address - Street 2:
Practice Address - City:BYRON CENTER
Practice Address - State:MI
Practice Address - Zip Code:49315-7928
Practice Address - Country:US
Practice Address - Phone:616-914-6148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI962109133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered