Provider Demographics
NPI:1497543409
Name:BOWERS, HEATHER NICOLE (RD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:NICOLE
Last Name:BOWERS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:686 WILLARD DR
Mailing Address - Street 2:
Mailing Address - City:CREEDMOOR
Mailing Address - State:NC
Mailing Address - Zip Code:27522-9771
Mailing Address - Country:US
Mailing Address - Phone:919-741-2874
Mailing Address - Fax:
Practice Address - Street 1:686 WILLARD DR
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522-9771
Practice Address - Country:US
Practice Address - Phone:919-741-2874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002670133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered