Individual
MIRIAM E FAHRER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1815 EDGEWOOD AVE, BURLINGTON, NC 27215-4505
(800) 632-6074
(866) 341-7509
Mailing address
PO BOX 10414, LARGO, FL 33773-0414
(800) 632-6074
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN050772
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6113009
—
NC
01
—
P11280560
RR MEDICARE # - PARADIGM
NC
Enumeration date
09/29/2006
Last updated
07/09/2007
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