Individual
CORI FAIRCLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
750 MORPHY AVE, FAIRHOPE, AL 36532-1812
(251) 990-1109
Mailing address
PO BOX 757, FLORENCE, AL 35631-0757
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001245540
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
3-002078
AL
Other
Enumeration date
06/28/2021
Last updated
02/16/2026
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