MEDICARE: SARAH EISWERT R.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian
2	133V00000X	Registered Dietitian	32574DI-0	NV

General Provider Information

NPI Number	:	1710381330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH EISWERT R.D.

Provider Business Mailing Address
First Line	:	3724 JEFFERSON ST STE 104
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-6204
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 E PATRIOT BLVD APT 274
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-1283
Country	:	US
Telephone Number	:	775-220-2689
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2014
Last Update Date	:	04/17/2024

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