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NPI Code Detail

MEDICARE: DR. DWIGHT FAUGHT DNP, RN. PMHNP-BC

MEDICARE:  DR. DWIGHT  FAUGHT  DNP, RN. PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner0024170328VA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAP7552AZ

General Provider Information

NPI Number : 1093050494
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DWIGHT FAUGHT DNP, RN. PMHNP-BC
Provider Business Mailing Address
First Line : 1204 FENWICK DR
Second Line :
City : LYNCHBURG
State : VA
Zip : 24502-2112
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4330 E UNIVERSITY DR
Second Line :
City : MESA
State : AZ
Zip : 85205-7004
Country : US
Telephone Number : 480-218-3280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2012
Last Update Date : 12/18/2021

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