Provider Demographics
NPI:1699361147
Name:ATLAS, SARAH ROSE (RD, LD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ROSE
Last Name:ATLAS
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7251 W LAKE MEAD BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-8380
Mailing Address - Country:US
Mailing Address - Phone:725-260-8605
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:7251 W LAKE MEAD BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-8380
Practice Address - Country:US
Practice Address - Phone:725-260-8605
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:No
Enumeration Date:2020-12-18
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV39840-DI-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered