Heather Brunk, RD

Individual provider Active NPI Registered Dietitian · Bridgewater, VA

NPI 1003672775 · NPPES record last updated Feb 21, 2024

Key facts

NPI
1003672775
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
86040354 (VA)
Practice address
37 Centerville Rd
Bridgewater, VA 22812-2700
Phone
(540) 241-5920
NPI assigned
Feb 21, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
86040354VAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Room at the Table Nutrition Services LLC Dietitian, Registered Current
since Feb 2, 2025
Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86040354 VA Yes

Addresses

Primary practice location

37 Centerville Rd
Bridgewater, VA 22812-2700

Mailing address

37 Centerville Rd
Bridgewater, VA 22812-2700
Phone (540) 241-5920

Other providers in Bridgewater, VA

All providers in Bridgewater, VA · Registered Dietitian in Virginia

Sources for this page

Verify at the official NPI Registry.