Provider Demographics
NPI:1649038621
Name:BURWELL, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BURWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 YANKEE HILL RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-7718
Mailing Address - Country:US
Mailing Address - Phone:402-328-6300
Mailing Address - Fax:
Practice Address - Street 1:4055 YANKEE HILL RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-7718
Practice Address - Country:US
Practice Address - Phone:402-328-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE86376846133V00000X
NE1784133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered