MEDICARE: MARIA VICTORIA SHANKLIN MS, RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1083564769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA VICTORIA SHANKLIN MS, RDN

Provider Business Mailing Address
First Line	:	1280 E VILLA VISTA AVE UNIT 342
Second Line	:
City	:	MILLCREEK
State	:	UT
Zip	:	84106-4750
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1280 E VILLA VISTA AVE UNIT 342
Second Line	:
City	:	MILLCREEK
State	:	UT
Zip	:	84106-4750
Country	:	US
Telephone Number	:	954-225-0407
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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