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NPI Code Detail

MEDICARE: KIMBERLY MIKELL FABER FNP

MEDICARE:   KIMBERLY MIKELL FABER  FNP
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
1363LF0000XFamily Nurse PractitionerAP4607AZ

General Provider Information

NPI Number : 1417200452
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY MIKELL FABER FNP
Provider Business Mailing Address
First Line : 2370 CORPORATE CIR STE 300
Second Line :
City : HENDERSON
State : NV
Zip : 89074-7760
Country : US
Telephone Number : 702-910-3950
Fax Number : 702-786-6650
Provider Business Practice Location Address
First Line : 6296 E GRANT RD STE 140
Second Line :
City : TUCSON
State : AZ
Zip : 85712-5876
Country : US
Telephone Number : 520-298-3321
Fax Number : 520-733-2305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2012
Last Update Date : 02/06/2021

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Directions to “ KIMBERLY MIKELL FABER FNP” Practice Location

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