Healthcare Provider Details

I. General information

NPI: 1407747355
Provider Name (Legal Business Name): SOFIA ALANAH GIANNINI MS, RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 RILEY HOSPITAL DR RM XE070
INDIANAPOLIS IN
46202-5272
US

IV. Provider business mailing address

12020 PARKVIEW LN
FISHERS IN
46038-1577
US

V. Phone/Fax

Practice location:
  • Phone: 317-435-6515
  • Fax:
Mailing address:
  • Phone: 317-435-6515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number37003796A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: