Provider Demographics
NPI:1912724428
Name:BERNDT, SARAH MATTISON (MS, RD, CSSD, RDN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MATTISON
Last Name:BERNDT
Suffix:
Gender:F
Credentials:MS, RD, CSSD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7462 ROLLING MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-9730
Mailing Address - Country:US
Mailing Address - Phone:608-556-0324
Mailing Address - Fax:
Practice Address - Street 1:7462 ROLLING MEADOW RD
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-9730
Practice Address - Country:US
Practice Address - Phone:608-556-0324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI967282133VN1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics