MEDICARE: SARAH MORGAN ADKISSON MS, RD, LDN

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
1	133V00000X	Registered Dietitian	L006891	NC

General Provider Information

NPI Number	:	1578338893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MORGAN ADKISSON MS, RD, LDN

Provider Business Mailing Address
First Line	:	302 YULAN DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2331
Country	:	US
Telephone Number	:	615-636-9143
Fax Number	:

Provider Business Practice Location Address
First Line	:	302 YULAN DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2331
Country	:	US
Telephone Number	:	615-636-9143
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2023
Last Update Date	:	11/16/2023

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