Provider Demographics
NPI:1578338893
Name:ADKISSON, SARAH MORGAN (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MORGAN
Last Name:ADKISSON
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 YULAN DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2331
Mailing Address - Country:US
Mailing Address - Phone:615-636-9143
Mailing Address - Fax:
Practice Address - Street 1:302 YULAN DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2331
Practice Address - Country:US
Practice Address - Phone:615-636-9143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL006891133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered