Individual
JESSICA NICOLE FAIRFAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 LIBERTY HILL RD, LUMBERTON, NC 28358-2446
(910) 739-3318
Mailing address
9833 OLD WHITEVILLE RD, LUMBERTON, NC 28358-7986
(910) 827-2412
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F07190414
NC
Other
Enumeration date
12/19/2019
Last updated
11/21/2024
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