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NPI Code Detail

MEDICARE: SARAH LASWELL RD

MEDICARE:   SARAH  LASWELL  RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1194671057
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH LASWELL RD
Provider Business Mailing Address
First Line : 1501 SPORTSMAN DR
Second Line :
City : JEFFERSONVILLE
State : IN
Zip : 47130-6156
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1501 SPORTSMAN DR
Second Line :
City : JEFFERSONVILLE
State : IN
Zip : 47130-6156
Country : US
Telephone Number : 502-991-1323
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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