EDITHA P. HEBERLEIN (NPI# 1770577348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770577348 |
| Entity Type | Individual |
| Full Name | EDITHA P. HEBERLEIN |
| Credential | M.S., R.D., FADA |
| Practice Address |
7300 N Perimeter Rd Malmstrom Afb MT 59402-6701 |
| Practice Telephone | 4067313863 |
| Practice Fax Number | 4067312691 |
| Mailing Telephone | 4067313863 |
| Mailing Fax Number | 4067312691 |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2012-03-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| Street Address |
7300 N PERIMETER RD |
| City | MALMSTROM AFB |
| State | MT |
| Zip Code | 59402-6701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205837184 | Deborah M Garrity | Pediatrics | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2005-08-02 |
| 1083220149 | Mayra Y Corona | Dental Assistant | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2020-09-23 |
| 1962012781 | Mercy Jean Padgett | Dental Hygienist | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2020-08-06 |
| 1720596810 | 341 Medical Group | Clinic/Center | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2018-01-11 |
| 1801305180 | Gabriella Seraphina Darrow | Dietitian, Registered | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2017-09-29 |
| 1134642036 | Nancy M Branch | Nurse Practitioner | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2017-07-23 |
| 1649623042 | Craig Brown | Dentist | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2016-07-20 |
| 1407222490 | Rachel Elder | Pharmacist | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2015-08-13 |
| 1710392352 | 341st Medical Group | Pharmacy | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2014-06-23 |
| 1265862478 | Michael Rohan | Military Health Care Provider | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2013-11-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194255166 | Jonathan Tankersley | Dentist | 7300 Perimeter Rd, Malmstrom Afb, Mt 59402, Dental Clinic, Apo, AA 59402 | 2017-06-13 |
| 1780061960 | Usv Optical Inc | Eyewear Supplier (Equipment, not the service) | 7200 Perimeter Rd., Bldg 1340, Malmstrom Afb, MT 59402 | 2015-04-27 |
| 1396181533 | 341st Medical Group | Military/U.S. Coast Guard Pharmacy | 341 Mdg/mdss/sgsa 7300 N Perimeter Rd, Bldg 2040, Malstrom Afb, MT 59402 | 2013-05-15 |
| 1205098258 | Dennis Gordon Vanhook | Social Worker | 7300 N Peirmeter Road, 341st Medical Group, Malmstrom Afb, MT 59402 | 2008-07-01 |
| 1437205119 | Misty Dawn Robertson | Dental Hygienist | 3700 N Perimeter Road, Malmstrom Afb, MT 59402 | 2007-01-26 |
| 1699738278 | Carol F Nelson | Nurse Practitioner | 7300 North Perimeter Rd, Malmstrom Afb, MT 59402 | 2006-04-06 |
| 1952541716 | Stacey Renee Vierra | Physician Assistant | 7300 North Perimeter Road, 341 Medical Group, Malmstrom Afb, MT 59402 | 2009-03-05 |
| 1306094461 | Jeremy Gustafson | Pharmacist | 7300 North Perimeter Road, Malmstrom Afb, MT 59402 | 2008-09-03 |
| 1356329817 | Timothy Paul Gacioch | Physician Assistant | 4300 Perimeter Rd, (341st Med Group) Bldg 2040, Room S156, Malmstrom Afb, MT 59402-0001 | 2006-01-05 |
| 1104848159 | Malmstrom Air Force Base | Military Hospital | 7300 N Perimeter Rd Bldg 2040, 341 Mdos/sgomhf Malmstrom Afb, Great Falls, MT 59402-6701 | 2006-07-25 |
| Find all providers in zip 59402 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801305180 | Gabriella Seraphina Darrow | Dietitian, Registered | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2017-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568077964 | Hannah Wilson | Dietitian, Registered | 224 Columbia Ave, Whitefish, MT 59937-2632 | 2020-09-11 |
| 1992319669 | Colleen Rose Mcmilin | Dietitian, Registered | 562 Enterprise Blvd Apt 49, Bozeman, MT 59718-5133 | 2020-09-01 |
| 1649893140 | Lorelei Nutrition | Dietitian, Registered | 213 N Broadway Ste 4, Billings, MT 59101-1972 | 2020-05-19 |
| 1366061913 | Amelia Tavares | Dietitian, Registered | 1 Valley View Dr Ste 104, Montana City, MT 59634-9203 | 2020-04-14 |
| 1093341133 | Chloe Lundquist | Dietitian, Registered | 626 1/2 W Galena St, Butte, MT 59701-1508 | 2020-03-20 |
| 1609401496 | Cailyn Schroeder | Dietitian, Registered | 117 Hideaway Trl, Livingston, MT 59047-8933 | 2020-03-11 |
| 1801431978 | Ashlee O'dell | Dietitian, Registered | 144 3rd St W Apt 3, Whitefish, MT 59937-3055 | 2019-11-13 |
| 1750933891 | Mercedes Seidel | Dietitian, Registered | 309 E Garfield St Apt F, Bozeman, MT 59715-5729 | 2019-07-09 |
| 1225696834 | Linda Kay Fredenberg | Dietitian, Registered | 1297 Burns Way Ste 3b, Kalispell, MT 59901-3162 | 2019-05-30 |
| 1659832939 | Rene Lindeen LLC | Dietitian, Registered | 1215 24th St W Ste 130, Billings, MT 59102-3895 | 2019-03-28 |
| Find all providers with the same taxonomy | ||||
| City | MALMSTROM AFB |
| Zip Code | 59402 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.