Provider Demographics
NPI:1780960492
Name:ALISIC, SABINA (LPN)
Entity type:Individual
Prefix:MRS
First Name:SABINA
Middle Name:
Last Name:ALISIC
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 1:507 EAST 25 STREET
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16503
Mailing Address - Country:US
Mailing Address - Phone:814-453-5420
Mailing Address - Fax:814-455-9440
Practice Address - Street 1:507 EAST 25 STREET
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16503
Practice Address - Country:US
Practice Address - Phone:814-453-5420
Practice Address - Fax:814-455-9440
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN283748164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse