Provider Demographics
NPI:1437956521
Name:WITHERSPOON, SABRINO ANN
Entity type:Individual
Prefix:MRS
First Name:SABRINO
Middle Name:ANN
Last Name:WITHERSPOON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SABRINO
Other - Middle Name:CALLOWAY
Other - Last Name:TEETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE
Mailing Address - Street 1:404 NE 6TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-6615
Mailing Address - Country:US
Mailing Address - Phone:434-441-1870
Mailing Address - Fax:
Practice Address - Street 1:4801 E LINWOOD BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64128-2226
Practice Address - Country:US
Practice Address - Phone:816-861-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002060360164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse