Provider Demographics
NPI:1699356279
Name:VOPICKA, SARA MARIE (MS, RDN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MARIE
Last Name:VOPICKA
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 BRIDLE PATH LN
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37074-3583
Mailing Address - Country:US
Mailing Address - Phone:708-710-1337
Mailing Address - Fax:
Practice Address - Street 1:932 E BADDOUR PKWY
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3707
Practice Address - Country:US
Practice Address - Phone:615-444-1836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered