Provider Demographics
NPI:1205624293
Name:HEER, CHARLOTTE (RDN, LRD)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:HEER
Suffix:
Gender:F
Credentials:RDN, LRD
Other - Prefix:
Other - First Name:CHAR
Other - Middle Name:
Other - Last Name:HEER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDN,LRD
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:HAZELTON
Mailing Address - State:ND
Mailing Address - Zip Code:58544-0355
Mailing Address - Country:US
Mailing Address - Phone:701-329-0926
Mailing Address - Fax:
Practice Address - Street 1:515 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4407
Practice Address - Country:US
Practice Address - Phone:701-323-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND422133V00000X
633103133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered