Provider Demographics
NPI:1538823190
Name:FORBES, SASHA (APRN, AGACNP)
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:
Last Name:FORBES
Suffix:
Gender:F
Credentials:APRN, AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7409 TEASWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1402
Mailing Address - Country:US
Mailing Address - Phone:903-360-1563
Mailing Address - Fax:
Practice Address - Street 1:7409 TEASWOOD DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1402
Practice Address - Country:US
Practice Address - Phone:903-360-1563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1055197363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty