Provider Demographics
NPI:1902442783
Name:SABEL, SHARON ROEBUCK (RN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ROEBUCK
Last Name:SABEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 SCHURING RD
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5037
Mailing Address - Country:US
Mailing Address - Phone:269-271-8266
Mailing Address - Fax:
Practice Address - Street 1:9616 PORTAGE RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-7257
Practice Address - Country:US
Practice Address - Phone:269-250-8200
Practice Address - Fax:269-250-8339
Is Sole Proprietor?:No
Enumeration Date:2019-11-27
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704245407163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse