Provider Demographics
NPI:1669011912
Name:BAPPE, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BAPPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 N WINN RD
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-7770
Mailing Address - Country:US
Mailing Address - Phone:605-431-5386
Mailing Address - Fax:
Practice Address - Street 1:321 W 12TH AVE # AVW
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-1314
Practice Address - Country:US
Practice Address - Phone:605-431-5386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-04
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0396133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist