Individual
PATSY FAULKENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-5555
Mailing address
22 LAUREL OAK AVE, FORT STEWART, GA 31315-2820
(912) 414-3716
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-049571
AL
Other
Enumeration date
09/15/2014
Last updated
09/15/2014
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