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Individual

MR. ALPHONZA FAISON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP, RN

Contact information

Practice address
5201 W MARKET ST STE 108, GREENSBORO, NC 27409
(336) 622-6000
Mailing address
307 VILLAGE LN UNIT B, GREENSBORO, NC 27409-2532

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
247595
NC
363L00000X
Nurse Practitioner
Primary
5011127
NC
363LF0000X
Family Nurse Practitioner
FAIS-PZ4Z48
NC

Other

Enumeration date
09/08/2018
Last updated
03/07/2019
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