Provider Demographics
NPI:1508595588
Name:SABIN, DIANA LEIGH (CRNA)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:LEIGH
Last Name:SABIN
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:PO BOX 277723
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-7723
Mailing Address - Country:US
Mailing Address - Phone:864-560-4123
Mailing Address - Fax:864-560-4023
Practice Address - Street 1:101 EAST WOOD STREET
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-4569
Practice Address - Country:US
Practice Address - Phone:864-560-6000
Practice Address - Fax:864-560-4023
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC.251550.R163W00000X
SC149806367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse