Provider Demographics
NPI:1093754079
Name:ABENIR, MARIBEL K (CRNA-NP)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:K
Last Name:ABENIR
Suffix:
Gender:F
Credentials:CRNA-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1101 FIRST COLONIAL RD 300
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2409
Mailing Address - Country:US
Mailing Address - Phone:757-481-4817
Mailing Address - Fax:757-481-7138
Practice Address - Street 1:200 MEDICAL PARK BLVD
Practice Address - Street 2:SOUTHSIDE REGIONAL MEDICAL CENTER
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9274
Practice Address - Country:US
Practice Address - Phone:804-765-5000
Practice Address - Fax:804-765-6250
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001144811367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered