Healthcare Provider Details

I. General information

NPI: 1831015361
Provider Name (Legal Business Name): THANDI HAUGHTON RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 W 66TH ST APT 548
EDINA MN
55435-5514
US

IV. Provider business mailing address

135 INTEGRA RESERVE LN APT 312
DEBARY FL
32713-9826
US

V. Phone/Fax

Practice location:
  • Phone: 612-502-4029
  • Fax:
Mailing address:
  • Phone: 612-502-4029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License NumberND7975
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: