Provider Demographics
NPI:1063212603
Name:ATKINSON, HEATHER JO (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:JO
Last Name:ATKINSON
Suffix:
Gender:
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 OEMLER LOOP
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-1704
Mailing Address - Country:US
Mailing Address - Phone:270-994-0993
Mailing Address - Fax:678-535-0982
Practice Address - Street 1:542 OEMLER LOOP
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-1704
Practice Address - Country:US
Practice Address - Phone:270-994-0993
Practice Address - Fax:678-535-0982
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003610133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered