Healthcare Provider Details

I. General information

NPI: 1366130361
Provider Name (Legal Business Name): SARA JEAN TURNER RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

379 N NIANGUA DR
NIXA MO
65714-8785
US

IV. Provider business mailing address

379 N NIANGUA DR
NIXA MO
65714-8785
US

V. Phone/Fax

Practice location:
  • Phone: 913-522-6848
  • Fax:
Mailing address:
  • Phone: 913-522-6848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2018013916
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: