Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Heidi Rose Brackebusch, RDN

Individual provider Registered Dietitian · NPI 1477415982

Heidi Rose Brackebusch, RDN is a Registered Dietitian OR Nutrition Professional in Coeur D Alene, Idaho. Qualified in 2023, 3 years ago. Practices as a sole proprietor and works from 3 locations. Licensed in Idaho.

Years since qualifying
3
Licensed in
ID
In the registry since
2025
What do these letters mean?
RDN — Registered Dietitian Nutritionist
The current title for a registered dietitian.

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Practice location Address checks out

1765 W Golf Course Rd
Coeur D Alene, ID 83815-9033
Phone: (208) 277-0795
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 — (208) 625-6664
  • 1610 E Schneidmiller Ave, Post Falls, ID 83854-7065 — (208) 773-8111

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 7671544 (ID)

Record details

NPI number1477415982
Entity typeIndividual (Type 1)
GenderFemale
Credentials RDN
Sole proprietorYes
NPI enumeratedDecember 2, 2025
Last updated in NPPESMay 13, 2026
Certification dateMay 13, 2026
Mailing address1917 N Lakewood Dr, Coeur D Alene, ID 83814-2634

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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