Provider Demographics
NPI:1326400755
Name:KOENINGER, SARAH C (RDN, LD)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:C
Last Name:KOENINGER
Suffix:
Gender:
Credentials:RDN, LD
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:C
Other - Last Name:PANGALLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 MADONNA LN
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:KY
Mailing Address - Zip Code:41076-1840
Mailing Address - Country:US
Mailing Address - Phone:859-240-3876
Mailing Address - Fax:
Practice Address - Street 1:4123 OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-3511
Practice Address - Country:US
Practice Address - Phone:859-301-6129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6499133V00000X
KY2311133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered