Provider Demographics
NPI:1043868102
Name:SABIC, ELVIS (ARNP)
Entity Type:Individual
Prefix:
First Name:ELVIS
Middle Name:
Last Name:SABIC
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 DIAMOND GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:RHODES
Mailing Address - State:IA
Mailing Address - Zip Code:50234-9748
Mailing Address - Country:US
Mailing Address - Phone:319-830-6821
Mailing Address - Fax:
Practice Address - Street 1:1825 LOGAN AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-1916
Practice Address - Country:US
Practice Address - Phone:319-235-3941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA155111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily