Individual provider Active NPI

Sabrina Holman

  • Licensed Practical Nurse
  • Fort Myers, FL
National Provider Identifier
1083140149
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5171988 Issued in FL
Practice address
2789 Ortiz Ave
Fort Myers, FL 33905-7806
Phone
(239) 275-3222
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN5171988 FL Primary

Addresses

Primary practice location

2789 Ortiz Ave
Fort Myers, FL 33905-7806

Mailing address

3763 Evans Ave
Fort Myers, FL 33901-9302
Phone (239) 275-3222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN5171988FLMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1083140149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3763 EVANS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019302",
            "telephone_number": "239-275-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2789 ORTIZ AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057806",
            "telephone_number": "239-275-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "SABRINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5171988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.