Provider Demographics
NPI:1356645840
Name:CROSBY, SANDRA TOLER
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:TOLER
Last Name:CROSBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:683 BULLARD AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-3248
Mailing Address - Country:US
Mailing Address - Phone:850-471-2088
Mailing Address - Fax:
Practice Address - Street 1:683 BULLARD AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-3248
Practice Address - Country:US
Practice Address - Phone:850-471-2088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility