Provider Demographics
NPI:1740477520
Name:HERMAN, KARLA BETH (RD)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:BETH
Last Name:HERMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:BETH
Other - Last Name:HERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:MT
Mailing Address - Zip Code:59327-0268
Mailing Address - Country:US
Mailing Address - Phone:406-346-2161
Mailing Address - Fax:406-346-4247
Practice Address - Street 1:383 N 17TH AVE
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:MT
Practice Address - Zip Code:59327-7971
Practice Address - Country:US
Practice Address - Phone:406-346-2161
Practice Address - Fax:406-346-4247
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT481133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT481OtherSTATE LICENSE