Provider Demographics
NPI:1992136832
Name:FABER, MAEGAN NICOLE (NP-C)
Entity type:Individual
Prefix:
First Name:MAEGAN
Middle Name:NICOLE
Last Name:FABER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MAEGAN
Other - Middle Name:NICOLE
Other - Last Name:PAPENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10000 BAY PINES BLVD
Mailing Address - Street 2:NEPHROLOGY CLINIC
Mailing Address - City:BAY PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33744-8200
Mailing Address - Country:US
Mailing Address - Phone:727-398-6661
Mailing Address - Fax:
Practice Address - Street 1:10000 BAY PINES BLVD
Practice Address - Street 2:NEPHROLOGY CLINIC
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744-8200
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9289383163W00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse