Provider Demographics
NPI:1457067753
Name:SABIR, ISRA SAMIA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ISRA
Middle Name:SAMIA
Last Name:SABIR
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 1:12801 N 111TH DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGTOWN
Mailing Address - State:AZ
Mailing Address - Zip Code:85363-1001
Mailing Address - Country:US
Mailing Address - Phone:315-317-1230
Mailing Address - Fax:
Practice Address - Street 1:330 N 16TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85007-2443
Practice Address - Country:US
Practice Address - Phone:602-257-3835
Practice Address - Fax:602-257-6397
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291412164W00000X
AZLP051875164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse