Provider Demographics
NPI:1093430803
Name:SARAH KIEL NUTRITION
Entity Type:Organization
Organization Name:SARAH KIEL NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KIEL
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:317-345-2655
Mailing Address - Street 1:514 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-1519
Mailing Address - Country:US
Mailing Address - Phone:317-345-2655
Mailing Address - Fax:
Practice Address - Street 1:514 E 22ND ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-1519
Practice Address - Country:US
Practice Address - Phone:317-345-2655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health