Provider Demographics
NPI:1730067893
Name:PATRICK, SARAH W (RDN)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:W
Last Name:PATRICK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1142 COUNTRY CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1474
Mailing Address - Country:US
Mailing Address - Phone:205-789-4003
Mailing Address - Fax:
Practice Address - Street 1:1142 COUNTRY CLUB CIR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1474
Practice Address - Country:US
Practice Address - Phone:205-789-4003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5635133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered