Provider Demographics
NPI:1740238971
Name:KRUGER, SARAH LYNN (MS, RD)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:LYNN
Last Name:KRUGER
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 HYLAND ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48915-2013
Mailing Address - Country:US
Mailing Address - Phone:517-862-2234
Mailing Address - Fax:517-788-4541
Practice Address - Street 1:900 E MICHIGAN AVE
Practice Address - Street 2:PROFESSIONAL CENTER EAST SUITE 104
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2457
Practice Address - Country:US
Practice Address - Phone:517-788-7866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Not Answered133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P33650Medicare ID - Type UnspecifiedPROVIDER ID