Provider Demographics
NPI:1386899748
Name:KLEINHANS, HEIDI ANN (RD)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANN
Last Name:KLEINHANS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:ANN
Other - Last Name:SHOEMAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1155 MILL ST # MS 14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:75 PRINGLE WAY STE 505
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-982-5437
Practice Address - Fax:775-982-3895
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV837989133V00000X
NV32885-DI-2133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV36574Medicare PIN