Basic Information
| Provider Information | |||||||||
| NPI: | 1093754079 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABENIR | ||||||||
| FirstName: | MARIBEL | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | CRNA-NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 FIRST COLONIAL RD 300 | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234542409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574814817 | ||||||||
| FaxNumber: | 7574817138 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 MEDICAL PARK BLVD | ||||||||
| Address2: | SOUTHSIDE REGIONAL MEDICAL CENTER | ||||||||
| City: | PETERSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 238059274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8047655000 | ||||||||
| FaxNumber: | 8047656250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 11/18/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 0001144811 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.