Healthcare Provider Details

I. General information

NPI: 1851359608
Provider Name (Legal Business Name): SARAH A. EIDER RD, RN, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6261 N LA CHOLLA BLVD STE 131
TUCSON AZ
85741-3556
US

IV. Provider business mailing address

2450 RIVERSIDE AVENUE
MINNEAPOLIS MN
55454-1450
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-5437
  • Fax: 520-694-4384
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2087
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number21510116
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN152993
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: