Provider Demographics
NPI:1750692455
Name:TITUS, HEIDI ELIZABETH (RD)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:ELIZABETH
Last Name:TITUS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:ELIZABETH
Other - Last Name:BORUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1481 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2803
Mailing Address - Country:US
Mailing Address - Phone:317-888-1875
Mailing Address - Fax:
Practice Address - Street 1:2669 COLD SPRING RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-6211
Practice Address - Country:US
Practice Address - Phone:317-888-1875
Practice Address - Fax:317-656-4034
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered