Doctor Name: | SARAH J PETERSON |
NPI Number: | 1194196667 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | 1016333 |
Business Practice Address: | 555 E Broadway Ave Ste 114 Jackson, WY - 830018640 |
Business Phone Number: | 3077397634 |
Business Fax Number: | 3077397632 |
Mailing Address: | Po Box 428, JACKSON |
State: | WY |
Postal Code: | 830010428 |
Phone Number: | 3077397634 |
Fax Number: | 3077397632 |
NPI Enumeration Date: | 10/09/2015 |
NPI Last Update Date: | 12/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 1016333 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |