Provider Demographics
NPI:1093037988
Name:HAVEMAN, SARAH LINNEA (RD, CDE)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:LINNEA
Last Name:HAVEMAN
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:LINNEA
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, CDE
Mailing Address - Street 1:PO BOX 863
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-0863
Mailing Address - Country:US
Mailing Address - Phone:515-956-2882
Mailing Address - Fax:515-956-2879
Practice Address - Street 1:1111 DUFF AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5745
Practice Address - Country:US
Practice Address - Phone:515-956-2882
Practice Address - Fax:515-956-2882
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01525133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered