Provider Demographics
NPI:1417758616
Name:NORTHERN HILLS NUTRITION AND DIETETICS, LLC
Entity type:Organization
Organization Name:NORTHERN HILLS NUTRITION AND DIETETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMOOT
Authorized Official - Suffix:
Authorized Official - Credentials:RDN LN
Authorized Official - Phone:480-285-5662
Mailing Address - Street 1:428 GOOSEBERRY RD
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-9008
Mailing Address - Country:US
Mailing Address - Phone:480-285-5662
Mailing Address - Fax:
Practice Address - Street 1:428 GOOSEBERRY RD
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-9008
Practice Address - Country:US
Practice Address - Phone:605-215-1838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty