Provider Demographics
NPI:1669123493
Name:CARMICKLE, SABRINA
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:CARMICKLE
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 1:2006 BROADWAY APT 207
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2431
Mailing Address - Country:US
Mailing Address - Phone:317-246-8696
Mailing Address - Fax:
Practice Address - Street 1:1500 21ST AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3160
Practice Address - Country:US
Practice Address - Phone:615-343-0265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other