Basic Information
| Provider Information | |||||||||
| NPI: | 1326466475 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FABER | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FLOYD | ||||||||
| OtherFirstName: | ERIN | ||||||||
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| OtherCredential: | DO | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 9705 LENEXA DR | ||||||||
| Address2: | |||||||||
| City: | LENEXA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662151345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162413338 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9705 LENEXA DR | ||||||||
| Address2: | |||||||||
| City: | LENEXA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162413338 | ||||||||
| FaxNumber: | 8169368118 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2014 | ||||||||
| LastUpdateDate: | 07/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZC0500X | 05-42142 | KS | N | Allopathic & Osteopathic Physicians | Pathology | Cytopathology | 207ZP0102X | 05-42142 | KS | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 2019024144 | 01 | MO | MISSOURI MEDICAL BOARD | OTHER | BP10062276 | 01 | TX | TEXAS MEDICAL BOARD | OTHER | E-11164 | 01 | AR | ARKANSAS STATE MEDICAL BOARD | OTHER | 05-42142 | 01 | KS | KANSAS MEDICAL LICENSE | OTHER | R3483 | 01 | KY | KENTUCKY BOARD OF MEDICAL LICENSURE | OTHER |