Provider Demographics
NPI:1497456404
Name:TROUT, SHANDI (RDN)
Entity type:Individual
Prefix:
First Name:SHANDI
Middle Name:
Last Name:TROUT
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1471 STONEHAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2427
Mailing Address - Country:US
Mailing Address - Phone:480-330-8264
Mailing Address - Fax:
Practice Address - Street 1:1471 STONEHAVEN AVE
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2427
Practice Address - Country:US
Practice Address - Phone:480-330-8264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty