Provider Demographics
NPI:1457758575
Name:COLLERAN, HEATHER L (PHD RDN CSSD LDN)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:L
Last Name:COLLERAN
Suffix:
Gender:F
Credentials:PHD RDN CSSD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 QUAKER LANDING RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2146
Mailing Address - Country:US
Mailing Address - Phone:336-908-0199
Mailing Address - Fax:
Practice Address - Street 1:3726B BATTLEGROUND AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2344
Practice Address - Country:US
Practice Address - Phone:336-908-0199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-04
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003302133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered