Provider Demographics
NPI:1588098206
Name:GROUT, ANNA LORAINE (MS, RD, CSSD, LD)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:LORAINE
Last Name:GROUT
Suffix:
Gender:F
Credentials:MS, RD, CSSD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 S. 3RD STREET
Mailing Address - Street 2:UNIT 202
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202
Mailing Address - Country:US
Mailing Address - Phone:502-526-8766
Mailing Address - Fax:888-972-1620
Practice Address - Street 1:2321 LIME KILN LN.
Practice Address - Street 2:UNIT B
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222
Practice Address - Country:US
Practice Address - Phone:502-526-8766
Practice Address - Fax:888-972-1620
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2068133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered