Provider Demographics
NPI:1801340096
Name:SABIN, AMANDA MARIE (CNA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:SABIN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2431 W BRADLEY AVE
Mailing Address - Street 2:APT L
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-1840
Mailing Address - Country:US
Mailing Address - Phone:217-766-6360
Mailing Address - Fax:
Practice Address - Street 1:2431 W BRADLEY AVE
Practice Address - Street 2:APT L
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-1840
Practice Address - Country:US
Practice Address - Phone:217-766-6360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide