Provider Demographics
NPI:1720496052
Name:EDWARDS, SABRINA LOUISE
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:LOUISE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 MOYER AVE
Mailing Address - Street 2:2
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-2441
Mailing Address - Country:US
Mailing Address - Phone:330-945-0400
Mailing Address - Fax:
Practice Address - Street 1:831 MOYER AVE
Practice Address - Street 2:2
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-2441
Practice Address - Country:US
Practice Address - Phone:330-945-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide