Provider Demographics
NPI:1851379242
Name:ACKERMAN, SABRINA KIM (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:KIM
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5478 HARBOUR CASTLE DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-7846
Mailing Address - Country:US
Mailing Address - Phone:941-916-3630
Mailing Address - Fax:
Practice Address - Street 1:11069 SEA TROPIC LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-8289
Practice Address - Country:US
Practice Address - Phone:800-437-5179
Practice Address - Fax:800-521-9318
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2867422367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303043100Medicaid
FLG2590Medicare ID - Type Unspecified