Provider Demographics
NPI:1699009837
Name:HARBIN, SARAH ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:HARBIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:HAVICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MHP
Mailing Address - Street 1:3310 FIELDS SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-3741
Mailing Address - Country:US
Mailing Address - Phone:217-902-9088
Mailing Address - Fax:
Practice Address - Street 1:3310 FIELDS SOUTH DR
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-3741
Practice Address - Country:US
Practice Address - Phone:217-902-9088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.028081363LF0000X
IL041.403303163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse