Provider Demographics
NPI:1679891584
Name:SORTINO, SARAH ANN (RD, LMNT)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ANN
Last Name:SORTINO
Suffix:
Gender:F
Credentials:RD, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3141
Mailing Address - Country:US
Mailing Address - Phone:402-553-2664
Mailing Address - Fax:402-553-4143
Practice Address - Street 1:5150 CENTER ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3141
Practice Address - Country:US
Practice Address - Phone:402-553-2664
Practice Address - Fax:402-553-7569
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01012965133V00000X
NE1180133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered