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NPI Code Detail

MEDICARE: SABRA L CONDRA FNP-C

MEDICARE: SABRA L CONDRA FNP-C
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
1363LF0000XFamily Nurse Practitioner0000025776TN

General Provider Information

NPI Number : 1316506967
Entity Type Code : Individual
Provider Name (Legal Business Name) : SABRA L CONDRA FNP-C
Provider Business Mailing Address
First Line : PO BOX 2930
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46206-2930
Country : US
Telephone Number : 866-282-7905
Fax Number : 855-630-1300
Provider Business Practice Location Address
First Line : 975 E 3RD ST
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37403-2163
Country : US
Telephone Number : 423-602-8400
Fax Number : 423-602-8401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2019
Last Update Date : 06/07/2019

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Directions to “ SABRA L CONDRA FNP-C” Practice Location

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