Individual
MS. MARY E FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RN, PHN
Contact information
Practice address
522 MINNESOTA AVE NW, BEMIDJI, MN 56601-3062
(218) 444-0488
(218) 444-0498
Mailing address
3225 DORAL DR NE, BEMIDJI, MN 56601-9063
(218) 444-0488
(218) 444-0498
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
R122592-3
MN
163WG0000X
General Practice Registered Nurse
Primary
R122592-3
MN
Other
Enumeration date
03/02/2007
Last updated
09/11/2025
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