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Individual
MR. KENNETH MICHAEL FAULKNER
Active
Individual
MR. KENNETH MICHAEL FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, RN, ANP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
234412
MA
163WC0200X
Critical Care Medicine Registered Nurse
512108-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F305502-1
NY
Other
Enumeration date
03/27/2012
Last updated
05/08/2012
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