Provider Demographics
NPI:1487953543
Name:ALLISON, SABRINA RENEA (LPN)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:RENEA
Last Name:ALLISON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:NY
Mailing Address - Zip Code:14530-1132
Mailing Address - Country:US
Mailing Address - Phone:585-969-4154
Mailing Address - Fax:
Practice Address - Street 1:5 HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:NY
Practice Address - Zip Code:14530-1132
Practice Address - Country:US
Practice Address - Phone:585-969-4154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305115164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse