Provider Demographics
NPI:1649556457
Name:FERRELL, SABRINA G (LPN)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:G
Last Name:FERRELL
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:PO BOX 132
Mailing Address - Street 2:
Mailing Address - City:SOUTH WEBSTER
Mailing Address - State:OH
Mailing Address - Zip Code:45682-0132
Mailing Address - Country:US
Mailing Address - Phone:740-250-4002
Mailing Address - Fax:
Practice Address - Street 1:67 FERGUSON AVE
Practice Address - Street 2:
Practice Address - City:SOUTH WEBSTER
Practice Address - State:OH
Practice Address - Zip Code:45682-8003
Practice Address - Country:US
Practice Address - Phone:740-250-4002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-146647-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse