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NPI Code Detail

MEDICARE: KAREN S FAIRCLOTH NP

MEDICARE: KAREN S FAIRCLOTH NP
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
1363L00000XNurse Practitioner1-030650AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265760060
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN S FAIRCLOTH NP
Provider Business Mailing Address
First Line : 333 CASTLEMAN LN
Second Line :
City : LEEDS
State : AL
Zip : 35094-3856
Country : US
Telephone Number : 205-699-6215
Fax Number :
Provider Business Practice Location Address
First Line : 2805 DR JOHN HAYNES DR
Second Line :
City : PELL CITY
State : AL
Zip : 35125-1448
Country : US
Telephone Number : 866-313-5260
Fax Number : 205-313-5245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2009
Last Update Date : 12/07/2009

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Directions to “ KAREN S FAIRCLOTH NP” Practice Location

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