Provider Demographics
NPI:1063164861
Name:NEVILLE, SARAH EMILY (MPH, RDN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:EMILY
Last Name:NEVILLE
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15025 W OLD OAK LN UNIT 1152
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-6187
Mailing Address - Country:US
Mailing Address - Phone:480-493-6094
Mailing Address - Fax:
Practice Address - Street 1:9825 N 95TH ST STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4590
Practice Address - Country:US
Practice Address - Phone:480-941-4247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-23
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ86059284133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered