MEDICARE: CHRISTINE FABEL CPNP

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	363LP0200X	Pediatric Nurse Practitioner	121242	MA

General Provider Information

NPI Number	:	1881785020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE FABEL CPNP

Provider Business Mailing Address
First Line	:	280 CHESTNUT ST
Second Line	:	2ND FLOOR
City	:	SPRINGFIELD
State	:	MA
Zip	:	01199-1000
Country	:	US
Telephone Number	:	413-794-5700
Fax Number	:	413-794-1629

Provider Business Practice Location Address
First Line	:	83 SOUTH ST
Second Line	:
City	:	WARE
State	:	MA
Zip	:	01082-1660
Country	:	US
Telephone Number	:	413-967-2040
Fax Number	:	413-967-2044

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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