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General NPI Number Information
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NPI Number | 1336208008
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Entity Type | Individual
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Provider Name | SARAH L BARNES RD, LD, CLC
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Gender | Female
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 06/15/2012
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Provider Practice Location Address
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Address Line | 79 BASTOGNE AVE CYSS CACFP
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City | FORT CAMPBELL
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State | KY
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Zip | 42223-5520
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Country | US
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Telephone | 931-216-7223
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Fax |
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Provider Business Mailing Address
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Address Line | 1141 DRAWBRIDGE CT
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City | CLARKSVILLE
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State | TN
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Zip | 37040-2513
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Country | US
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Telephone | 931-216-7223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2250
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License Number State | KY
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