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NPI Code Detail

MEDICARE: MARCO LORENZO FAJARDO

MEDICARE: MARCO LORENZO FAJARDO
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
1363LG0600XGerontology Nurse Practitioner5022373NC

General Provider Information

NPI Number : 1992509954
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCO LORENZO FAJARDO
Provider Business Mailing Address
First Line : 206 WESTBROOK DR
Second Line :
City : CARRBORO
State : NC
Zip : 27510-2447
Country : US
Telephone Number : 203-233-9261
Fax Number :
Provider Business Practice Location Address
First Line : 101 MANNING DR
Second Line :
City : CHAPEL HILL
State : NC
Zip : 27514-4220
Country : US
Telephone Number : 203-233-9261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2025
Last Update Date : 06/03/2026

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Directions to “ MARCO LORENZO FAJARDO ” Practice Location

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