Provider Demographics
NPI:1902974736
Name:ROSEBROOK, SARA LYNN (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:LYNN
Last Name:ROSEBROOK
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:MISS
Other - First Name:SARA
Other - Middle Name:LYNN
Other - Last Name:SORENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:571 N 260TH RD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:KS
Mailing Address - Zip Code:67423-9107
Mailing Address - Country:US
Mailing Address - Phone:785-436-2424
Mailing Address - Fax:
Practice Address - Street 1:511 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410-2153
Practice Address - Country:US
Practice Address - Phone:785-263-6676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1367133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered