Provider Demographics
NPI:1396454096
Name:ROGERS, SARAH ANN (RDN, LDN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:ROGERS
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 CEDAR VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ERIN
Mailing Address - State:TN
Mailing Address - Zip Code:37061-4468
Mailing Address - Country:US
Mailing Address - Phone:813-613-7293
Mailing Address - Fax:
Practice Address - Street 1:495 CEDAR VALLEY RD
Practice Address - Street 2:
Practice Address - City:ERIN
Practice Address - State:TN
Practice Address - Zip Code:37061-4468
Practice Address - Country:US
Practice Address - Phone:813-613-7293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY248016133V00000X
FLND9172133V00000X
TN3913133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered