Basic Information
| Provider Information | |||||||||
| NPI: | 1457543704 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARDIN | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | SAVANAH | ||||||||
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| Credential: | M.A., R.D., C.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 N STATE ST | ||||||||
| Address2: | |||||||||
| City: | GREENFIELD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461401270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3174684880 | ||||||||
| FaxNumber: | 3174684822 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 N STATE ST | ||||||||
| Address2: | |||||||||
| City: | GREENFIELD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461401270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3174684880 | ||||||||
| FaxNumber: | 3174684822 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2007 | ||||||||
| LastUpdateDate: | 08/10/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 958685 | IN | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.