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NPI Code Detail

MEDICARE: IRIS FAIRCLOTH ADAMS RN

MEDICARE: IRIS FAIRCLOTH ADAMS RN
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
1163W00000XRegistered Nurse039815NC

General Provider Information

NPI Number : 1932237161
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRIS FAIRCLOTH ADAMS RN
Provider Business Mailing Address
First Line : 2916 MYRTLE ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-3024
Country : US
Telephone Number : 336-641-6251
Fax Number :
Provider Business Practice Location Address
First Line : 1100 E WENDOVER AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-6713
Country : US
Telephone Number : 336-641-7777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 07/08/2007

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