Grace Ellen Moore, RDN
Dietitian, Registered in South Jordan, UT. Individual provider (NPI-1).
NPI number1164022919
StatusActive
Last updated in NPPESMar 13, 2024
Details
- NPI
- 1164022919
- Entity type
- Individual (NPI-1)
- Name
- Grace Ellen Moore
- Credential
- RDN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 30, 2020
- Certification date
- Mar 13, 2024
- Last updated
- Mar 13, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 86051484 | MD | Yes |
Practice location
5126 W Daybreak PkwySouth Jordan, UT 84009-5994
Phone 443-299-9623
Mailing address
1305 N Valentine StSalt Lake City, UT 84116-3627
Phone 443-299-9623
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All 12 Registered Dietitian providers in South Jordan · All 1,565 providers in South Jordan
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