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NPI 1932614120

NPI 1932614120 : REROOT NUTRITION : ANCHORAGE, AK

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General NPI Number Information
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    NPI Number           |    1932614120
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    Entity Type          |    Organization 
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    Legal Business Name  |    REROOT NUTRITION 
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Dates
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    Enumeration Date     |    12/09/2017
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    Last Update Date     |    02/24/2026
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Provider Practice Location Address
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    Address Line         |    7926 OLD SEWARD HWY STE A8 
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    City                 |    ANCHORAGE
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    State                |    AK
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    Zip                  |    99518-3261
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    Country              |    US
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    Telephone            |    907-921-1142
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7926 OLD SEWARD HWY STE A8 
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    City                 |    ANCHORAGE
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    State                |    AK
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    Zip                  |    99518-3261
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    Country              |    US
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    Telephone            |    907-921-1142
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER, REGISTERED DIETITIAN
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    Name                 |     KATHERINE  SWEETMAN 
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    Credential           |    RDN, CEDS, LD
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    Telephone            |    907-921-1142
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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       |    101188
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    License Number State |    AK
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