Provider Demographics
NPI:1851391346
Name:VANDER HART, SARAH A (MS, RD, CDE)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:VANDER HART
Suffix:
Gender:F
Credentials:MS, RD, CDE
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:DE VRIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2215 44TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-6439
Mailing Address - Country:US
Mailing Address - Phone:616-252-8438
Mailing Address - Fax:
Practice Address - Street 1:2215 44TH ST SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49509
Practice Address - Country:US
Practice Address - Phone:616-252-8438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered