Sullivan, Sarah Hazlegrove

Sullivan, Sarah Hazlegrove is an individual health care provider with primary practice located at 711 Jefferson Ave , Memphis TN 38105-5003. She recently has only one registered license in Dietary & Nutritional Service Providers / Nutrition, Metabolic, which is considered as her primary health care specialty. Sullivan, Sarah Hazlegrove can be contacted via phone (901) 448-6511.

Contact Information

Primary practice address
711 Jefferson Ave Memphis TN 38105-5003
Phone: (901) 448-6511
Fax: (901) 448-7097
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Metabolic 133VN1006X LDN2202 Tennessee

Profile Details

NPI number 1982936092
LBN Legal business name Sullivan, Sarah Hazlegrove
Credentials MS, RD, LDN
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2010
Last updated Sep 26th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982936092 NPPES
Tennessee Other 103I711459 MEDICARE PTAN
Tennessee MEDICAID 1519010 MEDICARE PTAN

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