Provider Demographics
NPI:1003432444
Name:WILLIAMS, SARA KAITLIN (RDN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:KAITLIN
Last Name:WILLIAMS
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 1:548 PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36067-3508
Mailing Address - Country:US
Mailing Address - Phone:334-782-5736
Mailing Address - Fax:
Practice Address - Street 1:548 PINECREST RD
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36067-3508
Practice Address - Country:US
Practice Address - Phone:334-782-5736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist