Provider Demographics
NPI:1588777536
Name:HEATH, JAIME LYNNE (RD,LD)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:LYNNE
Last Name:HEATH
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:MISS
Other - First Name:JAIME
Other - Middle Name:LYNNE
Other - Last Name:ABERLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:612 W 90TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-3547
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 CARONDELET DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4673
Practice Address - Country:US
Practice Address - Phone:816-943-4672
Practice Address - Fax:816-943-4719
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002007513133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered