MEDICARE: DR. JENNIFER D. FAULKNER PHARM.D.

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
1	1835P1300X	Psychiatric Pharmacist	37181	TX

General Provider Information

NPI Number	:	1386641017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER D. FAULKNER PHARM.D.

Provider Business Mailing Address
First Line	:	2263 HAMLET CIR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-6132
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 VETERANS MEMORIAL DR
Second Line	:	MHC 116
City	:	TEMPLE
State	:	TX
Zip	:	76504-7451
Country	:	US
Telephone Number	:	254-743-2867
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/31/2007

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