Provider Demographics
NPI:1467329110
Name:BARTZ, HERRON J (MS, CPT, RDN)
Entity type:Individual
Prefix:
First Name:HERRON
Middle Name:J
Last Name:BARTZ
Suffix:
Gender:F
Credentials:MS, CPT, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3804 HAZEL TRL UNIT D
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-8707
Mailing Address - Country:US
Mailing Address - Phone:952-451-8164
Mailing Address - Fax:
Practice Address - Street 1:3804 HAZEL TRL UNIT D
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-8707
Practice Address - Country:US
Practice Address - Phone:952-451-8164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-18
Last Update Date:2025-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty