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General NPI Number Information
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NPI Number | 1366994071
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Entity Type | Individual
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Provider Name | RANI FAULKENBERRY ATC, LAT, MA
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Gender | Female
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Dates
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Enumeration Date | 10/28/2016
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 2700 FM 1379
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City | MIDLAND
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State | TX
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Zip | 79706-5330
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Country | US
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Telephone | 432-683-6461
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Fax |
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Provider Business Mailing Address
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Address Line | 4701 YEARWOOD DR
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City | MIDLAND
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State | TX
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Zip | 79707-3157
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Country | US
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Telephone | 575-308-9286
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | AT5810
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License Number State | TX
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