Provider Demographics
NPI:1003853151
Name:SABOL, HEATHER JEAN (NP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:JEAN
Last Name:SABOL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MR
Other - First Name:HEATHER
Other - Middle Name:JEAN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, ANP
Mailing Address - Street 1:1000 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2597
Mailing Address - Country:US
Mailing Address - Phone:775-786-7200
Mailing Address - Fax:775-337-2238
Practice Address - Street 1:1000 LOCUST ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2597
Practice Address - Country:US
Practice Address - Phone:775-786-7200
Practice Address - Fax:775-337-2238
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1006635363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCQ58895Medicare UPIN
DC148565W17Medicare ID - Type Unspecified
MD40908700Medicare ID - Type Unspecified