Healthcare Provider Details

I. General information

NPI: 1821955626
Provider Name (Legal Business Name): AMBER DAWN FALCON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7121 US HIGHWAY 601 S
CONCORD NC
28025-8263
US

IV. Provider business mailing address

7121 US HIGHWAY 601 S
CONCORD NC
28025-8263
US

V. Phone/Fax

Practice location:
  • Phone: 910-257-7488
  • Fax:
Mailing address:
  • Phone: 910-257-7488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number240433
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: