Provider Demographics
NPI:1134924996
Name:LANDERS, SARI JANE (RDN, LDN)
Entity type:Individual
Prefix:
First Name:SARI
Middle Name:JANE
Last Name:LANDERS
Suffix:
Gender:
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:SARI
Other - Middle Name:JANE
Other - Last Name:STEADMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2850 HUNTERS LOOP UNIT C
Mailing Address - Street 2:
Mailing Address - City:BLACKFOOT
Mailing Address - State:ID
Mailing Address - Zip Code:83221-4943
Mailing Address - Country:US
Mailing Address - Phone:208-604-8337
Mailing Address - Fax:
Practice Address - Street 1:2327 CORONADO ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-7407
Practice Address - Country:US
Practice Address - Phone:208-528-1746
Practice Address - Fax:208-528-1934
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1371448133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered