Provider Demographics
NPI:1881823573
Name:NABER, KATHERINE (DO)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:NABER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3495 S CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48519-1455
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8447 HOLLY RD STE A
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2479
Practice Address - Country:US
Practice Address - Phone:810-695-7902
Practice Address - Fax:810-695-7908
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018240207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1881823573Medicaid
MI1881823573Medicare UPIN
MI1881823573Medicaid