Healthcare Provider Details

I. General information

NPI: 1396323127
Provider Name (Legal Business Name): SARAH MARIE BROWN RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 S JACKSON ST
MONTGOMERY AL
36104-4405
US

IV. Provider business mailing address

255 S JACKSON ST
MONTGOMERY AL
36104-4405
US

V. Phone/Fax

Practice location:
  • Phone: 334-263-1028
  • Fax: 334-263-0991
Mailing address:
  • Phone: 334-263-1028
  • Fax: 334-263-0991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number3100
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: