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NPI Code Detail

MEDICARE: HALEIGH FABAC RN

MEDICARE: HALEIGH FABAC RN
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
1163W00000XRegistered NurseRN.1688684CO

General Provider Information

NPI Number : 1306661764
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEIGH FABAC RN
Provider Business Mailing Address
First Line : 4430 S ADAMS COUNTY PKWY
Second Line :
City : BRIGHTON
State : CO
Zip : 80601-8222
Country : US
Telephone Number : 303-200-9200
Fax Number :
Provider Business Practice Location Address
First Line : 1401 W 122ND AVE STE 200
Second Line :
City : WESTMINSTER
State : CO
Zip : 80234-4902
Country : US
Telephone Number : 303-200-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2024
Last Update Date : 11/20/2024

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