MEDICARE: SABRINA HUMPHRIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172A00000X	Driver	RN453361	OH
2	172A00000X	Driver	RK884819	OH

General Provider Information

NPI Number	:	1518360270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRINA HUMPHRIES

Provider Business Mailing Address
First Line	:	972 ENGLEWOOD RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-2080
Country	:	US
Telephone Number	:	216-609-9281
Fax Number	:

Provider Business Practice Location Address
First Line	:	972 ENGLEWOOD RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-2080
Country	:	US
Telephone Number	:	216-609-9281
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2014
Last Update Date	:	10/14/2014

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Directions to “ SABRINA HUMPHRIES ” Practice Location

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