MEDICARE: MRS. KIMBERLY ANN FAULKNER N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APN7538	TN

General Provider Information

NPI Number	:	1659424968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY ANN FAULKNER N.P.

Provider Business Mailing Address
First Line	:	326 STARLING LN
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37064-8639
Country	:	US
Telephone Number	:	615-790-1626
Fax Number	:

Provider Business Practice Location Address
First Line	:	754 N MOUNT JULIET RD
Second Line	:
City	:	MT JULIET
State	:	TN
Zip	:	37122-3323
Country	:	US
Telephone Number	:	615-754-2828
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	07/08/2007

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