MEDICARE: ERIKA FABER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	4704342906	MI

General Provider Information

NPI Number	:	1407471915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA FABER

Provider Business Mailing Address
First Line	:	75 BUSCHLEN RD
Second Line	:
City	:	BAD AXE
State	:	MI
Zip	:	48413-9177
Country	:	US
Telephone Number	:	989-623-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 BUSCHLEN RD
Second Line	:
City	:	BAD AXE
State	:	MI
Zip	:	48413-9177
Country	:	US
Telephone Number	:	989-623-9300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2020
Last Update Date	:	11/06/2024

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