Provider Demographics
NPI:1942235593
Name:NUCKOLS, SABRINA D (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:D
Last Name:NUCKOLS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:SABRINA
Other - Middle Name:
Other - Last Name:MEADOWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3871 OLD HIGHWAY 278 EAST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903
Mailing Address - Country:US
Mailing Address - Phone:256-880-5818
Mailing Address - Fax:256-883-5346
Practice Address - Street 1:3871 OLD HIGHWAY 278 EAST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903
Practice Address - Country:US
Practice Address - Phone:256-251-3000
Practice Address - Fax:256-439-8548
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-070040363LF0000X
AL1070040363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily