Provider Demographics
NPI:1922676543
Name:RIENDEAU, HEIDI LYNN (CPM, LM)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:LYNN
Last Name:RIENDEAU
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 GLOVER ST
Mailing Address - Street 2:
Mailing Address - City:GLOVER
Mailing Address - State:VT
Mailing Address - Zip Code:05839-4432
Mailing Address - Country:US
Mailing Address - Phone:802-673-9824
Mailing Address - Fax:
Practice Address - Street 1:1037 S CRAFTSBURY RD
Practice Address - Street 2:
Practice Address - City:CRAFTSBURY
Practice Address - State:VT
Practice Address - Zip Code:05826-8008
Practice Address - Country:US
Practice Address - Phone:802-673-9824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT107.0129912176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife