Provider Demographics
NPI:1295995173
Name:DOERNEMAN, SARAH JF (MS, RD, LMNT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JF
Last Name:DOERNEMAN
Suffix:
Gender:F
Credentials:MS, RD, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 CENTENNIAL ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-7300
Mailing Address - Country:US
Mailing Address - Phone:402-615-3898
Mailing Address - Fax:
Practice Address - Street 1:1115 C ST
Practice Address - Street 2:
Practice Address - City:SCHUYLER
Practice Address - State:NE
Practice Address - Zip Code:68661-1913
Practice Address - Country:US
Practice Address - Phone:402-352-5135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE875133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE970153OtherCDR REGISTRATION NUMBER