MEDICARE: GLOW UP NUTRITION & FITNESS LLC

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	:	1275480196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOW UP NUTRITION & FITNESS LLC

Provider Business Mailing Address
First Line	:	8630 DRY NEEDLE PL
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80908-1368
Country	:	US
Telephone Number	:	720-441-2651
Fax Number	:

Provider Business Practice Location Address
First Line	:	8630 DRY NEEDLE PL
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80908-1368
Country	:	US
Telephone Number	:	720-441-2651
Fax Number	:

Authorized Official
Title or Position	:	OWNER/REGISTERED DIETITIAN
Name	:	SARAH SHORT
Credential	:	RD
Telephone Number	:	720-441-2651

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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