Healthcare Provider Details

I. General information

NPI: 1720713225
Provider Name (Legal Business Name): SARA ARNOLD MS, RD, CSSD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 N MADISON ST PO BOX 62
RAYMORE MO
64083
US

IV. Provider business mailing address

329 N MADISON ST PO BOX 62
RAYMORE MO
64083
US

V. Phone/Fax

Practice location:
  • Phone: 913-210-0474
  • Fax: 913-273-4853
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1501X
TaxonomySports Dietetics Nutrition Registered Dietitian
License Number86168654
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: