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General NPI Number Information
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NPI Number | 1083418388
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Entity Type | Individual
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Provider Name | TARMESSA FAULKNER
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Gender | Female
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 109 SHELBY WAY
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City | NICHOLASVILLE
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State | KY
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Zip | 40356-2695
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Country | US
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Telephone | 859-967-7159
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Fax |
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Provider Business Mailing Address
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Address Line | 1041 AUTUMN CREST LN
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City | LOUISVILLE
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State | KY
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Zip | 40245-3219
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Country | US
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Telephone | 859-967-7159
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 50109628
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License Number State | KY
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