IndividualActive
Shannon Sundberg, MS, RD, CD
NPI 1154670503 · Pediatric Nutrition Registered Dietitian · Salt Lake City, UT
Provider details
- NPI number
- 1154670503
- Entity type
- Individual
- Primary specialty
- Pediatric Nutrition Registered DietitianDietary & Nutritional Service Providers
- Credential
- MS, RD, CD
- Sex
- Female
- Sole proprietor
- Yes
- License
- 3781234901 (UT)
Practice location
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone: (801) 277-1207
Mailing address
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Registry dates
- Enumerated
- 2012-08-30
- Last updated
- 2012-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.