Provider Demographics
NPI:1982880381
Name:FABIAN, SANDRA ANN (APRN, BC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:ANN
Last Name:FABIAN
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6480A KIPAPA RD
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-8623
Mailing Address - Country:US
Mailing Address - Phone:808-821-0738
Mailing Address - Fax:
Practice Address - Street 1:3-3420 KUHIO HWY
Practice Address - Street 2:SUITE B
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1042
Practice Address - Country:US
Practice Address - Phone:808-245-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN 1030363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health