Provider Demographics
NPI:1013481175
Name:HAFNER, HEATHER ANNE (MS, RD, LDN, LD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:HAFNER
Suffix:
Gender:F
Credentials:MS, RD, LDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 S 5TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-8676
Mailing Address - Country:US
Mailing Address - Phone:814-297-8220
Mailing Address - Fax:814-297-8381
Practice Address - Street 1:1001 STATE ST STE 606
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1826
Practice Address - Country:US
Practice Address - Phone:814-454-3811
Practice Address - Fax:814-454-3422
Is Sole Proprietor?:No
Enumeration Date:2019-01-11
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006701133V00000X
OHLD09402133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered