Provider Demographics
NPI:1225400112
Name:ELLIOTT, SABRINA ROXANNE (LM, CPM)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:ROXANNE
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2204
Mailing Address - Country:US
Mailing Address - Phone:325-261-1146
Mailing Address - Fax:325-267-6488
Practice Address - Street 1:1233 NOTTINGHAM RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602
Practice Address - Country:US
Practice Address - Phone:325-261-1146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-30
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99392176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife