Provider Demographics
NPI:1699134981
Name:PATTERSON, SARA (RD, LD,CDE)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:RD, LD,CDE
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:COURTNEY
Other - Last Name:SUMMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 426
Mailing Address - Street 2:
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-0426
Mailing Address - Country:US
Mailing Address - Phone:620-432-5367
Mailing Address - Fax:620-431-7556
Practice Address - Street 1:629 S PLUMMER AVE
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-1928
Practice Address - Country:US
Practice Address - Phone:620-432-5367
Practice Address - Fax:620-431-7556
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1303133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered