Healthcare Provider Details

I. General information

NPI: 1487575353
Provider Name (Legal Business Name): GRIT & GRACE NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1829 90TH AVE
GREELEY CO
80634-5778
US

IV. Provider business mailing address

1829 90TH AVE
GREELEY CO
80634-5778
US

V. Phone/Fax

Practice location:
  • Phone: 720-684-7326
  • Fax:
Mailing address:
  • Phone: 720-684-7326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name: AMANDA PHILLIPS
Title or Position: OWNER
Credential: CNS, LDN, LN, HWC
Phone: 720-684-7326