Provider Demographics
NPI:1588253405
Name:UNDERRINER-WEBER, SARAH (RD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:UNDERRINER-WEBER
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EVANS ARMY COMMUNITY HOSPITAL, 1650 COCHRANE CIR B7500
Mailing Address - Street 2:
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-3400
Mailing Address - Country:US
Mailing Address - Phone:719-756-6505
Mailing Address - Fax:
Practice Address - Street 1:1650 COCHRANE CIR # B7500
Practice Address - Street 2:
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4613
Practice Address - Country:US
Practice Address - Phone:719-756-6505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR96702133VN1501X
960942133VN1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics