Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0101238509 | VA |
N | 111NI0900X | Internist | 0101238509 | VA |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 0101238509 | VA |
NPI | 1023113768 |
---|---|
Provider Name | Nelly A Maybee |
First Address | Fishersville, VA 22939-0388 |
Second Address | Fishersville, VA 22939 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 15/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1346205069 | FACILITY NPI (01) | VA |
1497719207 | FACILITY MED/SURGE NPI # (01) | VA |
1538124433 | FACILITY IPT NPI PROVIDER (01) | VA |
I63193 | (02) | VA |