Doctor Name: | SARA LAUREN PEACOCK |
NPI Number: | 1851755680 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, RD, LD |
License Number: | 1063048 |
Business Practice Address: | 411 Oak St Attn: Credentials Cincinnati, OH - 452192504 |
Business Phone Number: | 5139841800 |
Business Fax Number: | 5139844909 |
Mailing Address: | 4029 Redwing Ave, JACKSON |
State: | MS |
Postal Code: | 392163219 |
Phone Number: | 6017203194 |
Fax Number: | |
NPI Enumeration Date: | 04/07/2016 |
NPI Last Update Date: | 04/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 1063048 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
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 |