Healthcare Provider Details

I. General information

NPI: 1043009582
Provider Name (Legal Business Name): SARAH JEAN KLYM RDN,LRD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N 7TH ST
BISMARCK ND
58501-4439
US

IV. Provider business mailing address

300 N 7TH ST # 20710
BISMARCK ND
58501-4439
US

V. Phone/Fax

Practice location:
  • Phone: 701-323-6000
  • Fax: 701-323-8583
Mailing address:
  • Phone: 701-323-5676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1362
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: