Provider Demographics
NPI:1306326400
Name:AUBE, MARC EVARIST (FNP)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:EVARIST
Last Name:AUBE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:28 FITZPATRICK LN
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-1906
Mailing Address - Country:US
Mailing Address - Phone:413-221-0370
Mailing Address - Fax:
Practice Address - Street 1:300 STAFFORD ST STE 200
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3581
Practice Address - Country:US
Practice Address - Phone:413-276-6700
Practice Address - Fax:413-301-7123
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2265850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily