Provider Demographics
NPI:1073859575
Name:ALLEN, SARAH ARMINDA ENDRES (MS, RD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ARMINDA ENDRES
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 PARKER LOOP
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:38340-3724
Mailing Address - Country:US
Mailing Address - Phone:731-435-0044
Mailing Address - Fax:
Practice Address - Street 1:155 PARKER LOOP
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TN
Practice Address - Zip Code:38340-3724
Practice Address - Country:US
Practice Address - Phone:731-435-0044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-02
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000002437133V00000X
MDDX3365133V00000X
MEDI1122133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered