Provider Demographics
NPI:1952878720
Name:VAUBEL, PAIGE MARY (CNRA)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:MARY
Last Name:VAUBEL
Suffix:
Gender:F
Credentials:CNRA
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:MARY
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:159 ARION ST E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-1547
Mailing Address - Country:US
Mailing Address - Phone:952-807-8381
Mailing Address - Fax:
Practice Address - Street 1:333 SMITH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2344
Practice Address - Country:US
Practice Address - Phone:651-697-5804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN124953367500000X
390200000X
MN2283367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program