Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN1006635 | DC |
NPI | 1003853151 |
---|---|
Provider Name | Heather Jean Sabol |
First Address | Reno, NV 89502-2597 |
Second Address | Reno, NV 89502-2597 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q58895 | (02) | DC |