Sarah Gehring Provence, MS, RD, LDN, CDCES | |
2150 Dickens Place Dr, Southaven, MS 38672-7152 | |
(901) 387-7314 | |
Not Available |
Full Name | Sarah Gehring Provence |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 2150 Dickens Place Dr, Southaven, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1003476417 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | D1643 (Mississippi) | Primary |
133VN1004X | Dietitian, Registered - Nutrition, Pediatric | 2733 (Tennessee) | Secondary |
Provider Name | Nourish, Inc. |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1558097824 PECOS PAC ID: 1557724937 Enrollment ID: O20230901000471 |
Mailing Address | Practice Location Address |
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Sarah Gehring Provence, MS, RD, LDN, CDCES 2150 Dickens Place Dr, Southaven, MS 38672-7152 Ph: (901) 387-7314 | Sarah Gehring Provence, MS, RD, LDN, CDCES 2150 Dickens Place Dr, Southaven, MS 38672-7152 Ph: (901) 387-7314 |
Mrs. Jennifer E Moore, MS, RDN, LDN, CSR Dietitian Medicare: Medicare Enrolled Practice Location: 3870 Liscott Rd, Southaven, MS 38672 Phone: 702-533-2259 | |
Mr. John Michael Dudley, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 6856 Cobblestone Blvd, Southaven, MS 38672 Phone: 888-416-0008 | |
Heather Ruthann Jenkins, RDN,LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2646 Cherry Tree Dr, Southaven, MS 38672 Phone: 662-394-1789 | |
Mrs. Shirley T Davis, RDN LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 6856 Cobblestone Blvd, Southaven, MS 38672 Phone: 888-416-0008 Fax: 888-416-0009 | |
Mrs. Emily Kesler Schwartz, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 7601 Southcrest Pkwy, Southaven, MS 38671 Phone: 662-772-3185 Fax: 662-772-3197 | |
Jamarcus B Frazier, RDN Dietitian Medicare: Medicare Enrolled Practice Location: 8416 Inverness Dr, Southaven, MS 38672 Phone: 901-210-1523 |