Provider Demographics
NPI:1871917724
Name:JABER, VERA
Entity type:Individual
Prefix:MRS
First Name:VERA
Middle Name:
Last Name:JABER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7060
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48121-7060
Mailing Address - Country:US
Mailing Address - Phone:313-413-8684
Mailing Address - Fax:888-242-0942
Practice Address - Street 1:10140 VERNOR HWY
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1515
Practice Address - Country:US
Practice Address - Phone:313-413-8684
Practice Address - Fax:888-242-0942
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704267744363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner