Provider Demographics
NPI:1508372392
Name:WATKINS, SABRE THOMAS (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SABRE
Middle Name:THOMAS
Last Name:WATKINS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7506 E INDEPENDENCE BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-9456
Mailing Address - Country:US
Mailing Address - Phone:704-266-0544
Mailing Address - Fax:
Practice Address - Street 1:5855 EXECUTIVE CENTER DR STE 111
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-8880
Practice Address - Country:US
Practice Address - Phone:980-298-8493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-16
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010120363LF0000X, 363LP0808X
NCWATK-QPVF31363LF0000X
NC50101020363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty