Healthcare Provider Details

I. General information

NPI: 1881153377
Provider Name (Legal Business Name): SABRINA KIFER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 09/23/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7629 MARKET ST STE 100
BOARDMAN OH
44512-6051
US

IV. Provider business mailing address

1403 KEARNEY ST
NILES OH
44446-3841
US

V. Phone/Fax

Practice location:
  • Phone: 330-965-4880
  • Fax:
Mailing address:
  • Phone: 330-507-0111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number024222
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: