Individual
DR. ALLAN MARCOS FAIRCLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, PMHNP-BC, RN
Contact information
Practice address
1901 ADAMS FARM PKWY, GREENSBORO, NC 27407-6338
(336) 722-7266
Mailing address
301 KING ST APT 1E, GREENSBORO, NC 27406-1699
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
271994
NC
363L00000X
Nurse Practitioner
Primary
5014648
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5014648
NC
Other
Enumeration date
08/10/2017
Last updated
05/11/2022
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