Healthcare Provider Details

I. General information

NPI: 1851201180
Provider Name (Legal Business Name): THE NUTRITION SANCTUARY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3237 GREEN FARM TRL
DACULA GA
30019-2964
US

IV. Provider business mailing address

3237 GREEN FARM TRL
DACULA GA
30019-2964
US

V. Phone/Fax

Practice location:
  • Phone: 207-485-4318
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: SARAH ELLEN JORDAN
Title or Position: REGISTERED DIETITIAN
Credential: MS,RD, LD
Phone: 207-485-4318