MEDICARE: MRS. SARAH M BURNETT M.S., R.D., L,D.

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	LD002697	GA

General Provider Information

NPI Number	:	1740352327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH M BURNETT M.S., R.D., L,D.

Provider Business Mailing Address
First Line	:	59 NEW LIBERTY TRL
Second Line	:
City	:	ELLIJAY
State	:	GA
Zip	:	30536-4755
Country	:	US
Telephone Number	:	706-273-6999
Fax Number	:

Provider Business Practice Location Address
First Line	:	59 NEW LIBERTY TRL
Second Line	:
City	:	ELLIJAY
State	:	GA
Zip	:	30536-4755
Country	:	US
Telephone Number	:	706-273-6999
Fax Number	:

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	06/20/2016

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Directions to “ MRS. SARAH M BURNETT M.S., R.D., L,D.” Practice Location

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