Provider Demographics
NPI:1851468631
Name:LUEBBEN, MARY MARGARET (FNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:LUEBBEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-564-7094
Mailing Address - Fax:540-564-7171
Practice Address - Street 1:1790 E MARKET ST
Practice Address - Street 2:SUITE 64B
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-5114
Practice Address - Country:US
Practice Address - Phone:540-564-5622
Practice Address - Fax:540-433-0623
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA002416541363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily