Active NPI
Gina Fabiano, LAC
- Acupuncturist
- Maple Grove, MN
National Provider Identifier
1104252832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 1669
- Practice address
- 9325 Upland LN N Ste 240
Maple Grove, MN 55369-4486 - Phone
- (763) 494-9500
- NPI assigned
- Sep 26, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 1669 | MN | Primary |
Addresses
Primary practice location
9325 Upland LN N Ste 240
Maple Grove, MN 55369-4486
Mailing address
2191 Knapp St
Saint Paul, MN 55108-1906
Phone (208) 720-1974
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1669 | MN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380153600000",
"number": "1104252832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2191 KNAPP ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551081906",
"telephone_number": "208-720-1974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9325 UPLAND LN N STE 240",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553694486",
"telephone_number": "763-494-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABIANO",
"first_name": "GINA",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-26",
"last_updated": "2013-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MN",
"license": "1669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.