Pack-Mabien, Ardie Vanessa

Pack-Mabien, Ardie Vanessa is an individual health care provider with primary practice located at 1601 Center St Ste 1S, Mobile AL 36604-1512. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Pack-Mabien, Ardie Vanessa can be contacted via phone (251) 410-5437.

Contact Information

Primary practice address
1601 Center St Ste 1S Mobile AL 36604-1512
Phone: (251) 410-5437
Fax: (251) 434-3852
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1-050071 Alabama

Profile Details

NPI number 1891740981
LBN Legal business name Pack-Mabien, Ardie Vanessa
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Mar 3rd, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891740981 NPPES
Mississippi MEDICAID 00124955
Mississippi MEDICAID 304248100
Mississippi Other 51505390
Mississippi MEDICAID 891003660

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