Individual provider · Type 1 NPI

Mara Nicole Humberg, NP

Pediatric Nurse Practitioner · Lafayette, IN

NPI number 1760089445 Active

Practice location

2316 South St
Lafayette, IN 47904-2971

Fax (765) 742-2750

Mailing address

1716 Hartford St
Lafayette, IN 47904-2138

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X71011419A (IN)
Registered Nurse 163W00000X28224434A (IN)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1760089445

Mara Nicole Humberg, NP's National Provider Identifier is 1760089445, issued on Oct 6, 2020. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Lafayette, IN. The record was last updated on May 9, 2022.