Provider Demographics
NPI:1104398627
Name:BUSH, SARAH ABBITT (MS, RD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ABBITT
Last Name:BUSH
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 1:258 DAREL ST
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28457-1333
Mailing Address - Country:US
Mailing Address - Phone:252-333-7052
Mailing Address - Fax:
Practice Address - Street 1:258 DAREL ST
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NC
Practice Address - Zip Code:28457-1333
Practice Address - Country:US
Practice Address - Phone:252-333-7052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL005261133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered