Individual
NIKKI CLAIRE FAULCONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
759 27TH AVE, SWEET HOME, OR 97386-2994
(541) 619-8697
Mailing address
337 W JADON DR, LEBANON, OR 97355-1688
(541) 401-8029
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201141800RN
OR
Other
Enumeration date
07/21/2011
Last updated
07/03/2012
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