Healthcare Provider Details

I. General information

NPI: 1891796066
Provider Name (Legal Business Name): HEIDI NABER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 W WISER LAKE RD
FERNDALE WA
98248-9421
US

IV. Provider business mailing address

149 W WISER LAKE RD
FERNDALE WA
98248-9421
US

V. Phone/Fax

Practice location:
  • Phone: 360-354-3312
  • Fax:
Mailing address:
  • Phone: 360-354-3312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License NumberRN00101483
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: