Provider Demographics
NPI:1932671724
Name:PRINGLE, SABRENA
Entity Type:Individual
Prefix:
First Name:SABRENA
Middle Name:
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 SPEARFISH PL
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4370
Mailing Address - Country:US
Mailing Address - Phone:202-213-5129
Mailing Address - Fax:
Practice Address - Street 1:3110 ESTHER PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-1505
Practice Address - Country:US
Practice Address - Phone:202-594-5141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
5802124-DC10OtherBLUE CROSS BLUE SHEILD