Provider Demographics
NPI:1427502103
Name:STIMPSON, SARAH LYNN (RDN, CDN)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:LYNN
Last Name:STIMPSON
Suffix:
Gender:F
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 WELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-2417
Mailing Address - Country:US
Mailing Address - Phone:716-510-6905
Mailing Address - Fax:
Practice Address - Street 1:155 WELLINGTON RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216-2417
Practice Address - Country:US
Practice Address - Phone:716-510-6905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY975057133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered