Provider Demographics
NPI:1689440117
Name:MABIL, ATONG
Entity Type:Individual
Prefix:
First Name:ATONG
Middle Name:
Last Name:MABIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 BLUESTEM DR APT 3140
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8034
Mailing Address - Country:US
Mailing Address - Phone:701-936-9041
Mailing Address - Fax:
Practice Address - Street 1:2915 BLUESTEM DR APT 3140
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8034
Practice Address - Country:US
Practice Address - Phone:701-936-9041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker