Healthcare Provider Details

I. General information

NPI: 1194298539
Provider Name (Legal Business Name): JENNIFER MARIE SANABIA APRN-RNP, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2019
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 GALLETTI WAY
SPARKS NV
89431-5544
US

IV. Provider business mailing address

1001 RIO VISTA DR
FALLON NV
89406-5463
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-8870
  • Fax: 775-982-8871
Mailing address:
  • Phone: 775-453-4815
  • Fax: 313-789-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP220826
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP220826
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number830391
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number830391
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number830391
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: