Provider Demographics
NPI:1144535345
Name:SABER, EVALLYNN KORINN
Entity type:Individual
Prefix:
First Name:EVALLYNN
Middle Name:KORINN
Last Name:SABER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 392
Mailing Address - Street 2:
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-0392
Mailing Address - Country:US
Mailing Address - Phone:952-457-9288
Mailing Address - Fax:
Practice Address - Street 1:202 3RD AVE SE APT 1
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MN
Practice Address - Zip Code:55049-5603
Practice Address - Country:US
Practice Address - Phone:952-457-9288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant