Healthcare Provider Details

I. General information

NPI: 1104854504
Provider Name (Legal Business Name): GINA M. FARRINGER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2469 WENDELL BLVD
WENDELL NC
27591-6903
US

IV. Provider business mailing address

PO BOX 1985
WENDELL NC
27591-1985
US

V. Phone/Fax

Practice location:
  • Phone: 919-365-9045
  • Fax: 919-365-9046
Mailing address:
  • Phone: 919-365-9045
  • Fax: 919-365-9046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201402
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: