1144742685 NPI number — MRS. JENNIFER NICOLE NABER IBCLC

Table of content: MRS. JENNIFER NICOLE NABER IBCLC (NPI 1144742685)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144742685 NPI number — MRS. JENNIFER NICOLE NABER IBCLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NABER
Provider First Name:
JENNIFER
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
IBCLC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLOYED
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144742685
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11331 GATESVILLE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75035-9113
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-979-0231
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11331 GATESVILLE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRISCO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75035-9113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-979-0231
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WL0100X , with the licence number:  L-121866 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com