Provider Demographics
NPI:1881023836
Name:NEBA, MABEL FRI
Entity Type:Individual
Prefix:MRS
First Name:MABEL
Middle Name:FRI
Last Name:NEBA
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 1:7476 STONETRAIL WAY APT B
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-4280
Mailing Address - Country:US
Mailing Address - Phone:614-284-1339
Mailing Address - Fax:
Practice Address - Street 1:7476 STONETRAIL WAY APT B
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-4280
Practice Address - Country:US
Practice Address - Phone:614-284-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-09
Last Update Date:2013-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH151873164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse