Provider Demographics
NPI:1548586928
Name:WERTZ, SABRINA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:
Last Name:WERTZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6452 WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-1921
Mailing Address - Country:US
Mailing Address - Phone:315-533-6121
Mailing Address - Fax:
Practice Address - Street 1:6452 WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-1921
Practice Address - Country:US
Practice Address - Phone:315-533-6121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-11
Last Update Date:2010-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293016164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse