Provider Demographics
NPI:1083250187
Name:DELPRIORE, HEATHER RUTHANN (RDN,LD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:RUTHANN
Last Name:DELPRIORE
Suffix:
Gender:F
Credentials:RDN,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7345 FULTON SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-9814
Mailing Address - Country:US
Mailing Address - Phone:662-394-1789
Mailing Address - Fax:
Practice Address - Street 1:8295 TOURNAMENT DR STE 150
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-8900
Practice Address - Country:US
Practice Address - Phone:662-394-1789
Practice Address - Fax:844-927-4739
Is Sole Proprietor?:No
Enumeration Date:2019-11-23
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD0813133V00000X
TNLDN0000004603133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered