Provider Demographics
NPI:1851359608
Name:EIDER, SARAH A (RD, RN, CDCES)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:EIDER
Suffix:
Gender:F
Credentials:RD, RN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 RIVERSIDE AVENUE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1450
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6261 N LA CHOLLA BLVD STE 131
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3556
Practice Address - Country:US
Practice Address - Phone:520-694-5437
Practice Address - Fax:520-694-4384
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2087133V00000X
AZ21510116163WD0400X
AZRN152993163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered