MEDICARE: SABRINA NOELLE CASSIDY ARNP

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	363LF0000X	Family Nurse Practitioner	29655	SC
2	363LF0000X	Family Nurse Practitioner	4704349572	MI
3	363LF0000X	Family Nurse Practitioner	86583	NM
4	363LF0000X	Family Nurse Practitioner	0024195484	VA
5	363LF0000X	Family Nurse Practitioner	A190240	IA
6	363LF0000X	Family Nurse Practitioner	APRN.CNP.0037985	OH
7	363LF0000X	Family Nurse Practitioner	1182776	TX
8	363LF0000X	Family Nurse Practitioner	GAA-NP003004	GA
9	363LF0000X	Family Nurse Practitioner	AP61627345	WA
10	363LF0000X	Family Nurse Practitioner	4029892	KY
11	363LF0000X	Family Nurse Practitioner	APRN9269862	FL
12	363LF0000X	Family Nurse Practitioner	3-001958	CO
13	363LF0000X	Family Nurse Practitioner	3-001958	AL

General Provider Information

NPI Number	:	1366996076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRINA NOELLE CASSIDY ARNP

Provider Business Mailing Address
First Line	:	PO BOX 211699
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55121-3699
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 HOWELL MILL RD NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-5557
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:

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

Provider Enumeration Date	:	08/10/2016
Last Update Date	:	03/25/2026

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