Provider Demographics
NPI:1881710564
Name:CHRISTIANSEN, SARA CASE (RD, LD, NSCA-CPT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:CASE
Last Name:CHRISTIANSEN
Suffix:
Gender:
Credentials:RD, LD, NSCA-CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8398 UNIONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:62910-2503
Mailing Address - Country:US
Mailing Address - Phone:270-564-5782
Mailing Address - Fax:
Practice Address - Street 1:2021 BROADWAY ST STE 103
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-7103
Practice Address - Country:US
Practice Address - Phone:270-415-5616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1973133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered