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Individual
MRS. SHAWANA AVRE FAULK
Active
Individual
MRS. SHAWANA AVRE FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5005504
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171PU
BCBSNC
NC
05
—
7005953
—
NC
01
—
P01243890
RAILROAD MEDICARE
NC
Enumeration date
02/04/2012
Last updated
03/07/2023
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