Provider Demographics
NPI:1891521142
Name:KINSEY, SARAH ROSE (RDN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ROSE
Last Name:KINSEY
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 1:4601 N VIA ENTRADA APT 2082
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5874
Mailing Address - Country:US
Mailing Address - Phone:602-579-4080
Mailing Address - Fax:
Practice Address - Street 1:4601 N VIA ENTRADA APT 2082
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-5874
Practice Address - Country:US
Practice Address - Phone:602-579-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ86392799133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered