Provider Demographics
NPI:1902262538
Name:SABIROVA, MARINA (CRNA)
Entity Type:Individual
Prefix:MISS
First Name:MARINA
Middle Name:
Last Name:SABIROVA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12220 PELLICANO DR
Mailing Address - Street 2:516
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6834
Mailing Address - Country:US
Mailing Address - Phone:915-203-3244
Mailing Address - Fax:
Practice Address - Street 1:12220 PELLICANO DR
Practice Address - Street 2:516
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6834
Practice Address - Country:US
Practice Address - Phone:915-203-3244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX751274367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered