Provider Demographics
NPI:1497416838
Name:HEYING, EMILY (PHD, RD, LD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HEYING
Suffix:
Gender:F
Credentials:PHD, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9705 45TH AVE N # 41005
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55442-2555
Mailing Address - Country:US
Mailing Address - Phone:641-750-5844
Mailing Address - Fax:
Practice Address - Street 1:37 COLLEGE AVE S
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MN
Practice Address - Zip Code:56374-2001
Practice Address - Country:US
Practice Address - Phone:641-750-5844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4549133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered