Provider Demographics
NPI:1346913787
Name:NABBIE, SASHA (APRN BC)
Entity type:Individual
Prefix:MRS
First Name:SASHA
Middle Name:
Last Name:NABBIE
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 1:675 S. BABCOCK ST.
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-1459
Mailing Address - Country:US
Mailing Address - Phone:321-951-1010
Mailing Address - Fax:321-952-4038
Practice Address - Street 1:5200 BABCOCK ST NE
Practice Address - Street 2:107
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905
Practice Address - Country:US
Practice Address - Phone:321-729-9306
Practice Address - Fax:321-729-8050
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014395363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner