Provider Demographics
NPI:1518298223
Name:OVERHOLT, SARAH MAYFIELD (RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:MAYFIELD
Last Name:OVERHOLT
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 202
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:NC
Mailing Address - Zip Code:27860-0202
Mailing Address - Country:US
Mailing Address - Phone:252-943-6689
Mailing Address - Fax:
Practice Address - Street 1:198 NC HIGHWAY 45 N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NC
Practice Address - Zip Code:27962-9232
Practice Address - Country:US
Practice Address - Phone:252-791-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00982658133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered