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General NPI Number Information
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NPI Number | 1689505190
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Entity Type | Organization
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Legal Business Name | FAUNTLEROY HEALTHCARE AND OUTREACH CONSULTING
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Dates
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Enumeration Date | 05/26/2026
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Last Update Date | 05/26/2026
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Provider Practice Location Address
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Address Line | 10 COMFORT RD
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-2969
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Country | US
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Telephone | 856-725-0878
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Fax |
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Provider Business Mailing Address
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Address Line | 10 COMFORT RD
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-2969
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Country | US
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Telephone | 856-725-0878
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MS. LISA ANTOINETTE FAUNTLEROY
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Credential | RN,BSN,CCHP
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Telephone | 856-725-0878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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