Provider Demographics
NPI:1194399972
Name:FITZGERALD, SARAH HOPE (RD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:HOPE
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:HOPE
Other - Middle Name:FITZGERALD
Other - Last Name:BRANDT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:3880 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-1098
Mailing Address - Country:US
Mailing Address - Phone:985-290-8611
Mailing Address - Fax:
Practice Address - Street 1:3880 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-1098
Practice Address - Country:US
Practice Address - Phone:985-290-8611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered