Provider Demographics
NPI:1831779123
Name:SABO, KRISTI (RN)
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:
Last Name:SABO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 ALGOMA SPUR RD
Mailing Address - Street 2:
Mailing Address - City:SAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83860-8401
Mailing Address - Country:US
Mailing Address - Phone:208-255-9997
Mailing Address - Fax:
Practice Address - Street 1:1600 ALGOMA SPUR RD
Practice Address - Street 2:
Practice Address - City:SAGLE
Practice Address - State:ID
Practice Address - Zip Code:83860-8401
Practice Address - Country:US
Practice Address - Phone:208-255-9997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-10
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID2238163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice