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Individual
ARDIE VANESSA PACK-MABIEN
Active
Individual
ARDIE VANESSA PACK-MABIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-050071
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124955
—
MS
05
—
304248100
—
FL
01
—
51505390
BLUE CROSS
AL
05
—
891003660
—
AL
Enumeration date
05/24/2006
Last updated
03/03/2017
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