Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 26NN07014600 | NJ |
NPI | 1992741565 |
---|---|
Provider Name | Ms. Carolyn Elizabeth Fabian |
First Address | Cherry Hill, NJ 08034-2760 |
Second Address | Voorhees, NJ 08043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 08/07/2007 |