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NPI Code Detail

MEDICARE: MRS. LAUREN BROOKE FAULKNER APN

MEDICARE: MRS. LAUREN BROOKE FAULKNER APN
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
1363LF0000XFamily Nurse PractitionerA03650AR
2363LF0000XFamily Nurse PractitionerA003650AR

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 : 1710259049
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAUREN BROOKE FAULKNER APN
Provider Business Mailing Address
First Line : 465 MEDICAL CENTER PARKWAY
Second Line :
City : CLINTON
State : AR
Zip : 72031-6873
Country : US
Telephone Number : 501-745-7888
Fax Number : 501-745-4401
Provider Business Practice Location Address
First Line : 465 MEDICAL CENTER PARKWAY
Second Line :
City : CLINTON
State : AR
Zip : 72031-1529
Country : US
Telephone Number : 501-745-7888
Fax Number : 501-745-4401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2012
Last Update Date : 03/17/2018

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