Individual
MRS. JORDAN MICHALEA FAREWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7910 US HWY 117 S UNIT 120, ROCKY POINT, NC 28457-7409
(910) 300-4500
(910) 550-3787
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 300-4500
(910) 675-3030
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5018925
NC
363LP2300X
Primary Care Nurse Practitioner
FARE-3C9AF
NC
Other
Enumeration date
08/31/2023
Last updated
03/18/2025
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