Individual
AMY ELIZABETH FARGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
1309 N ELM ST, GREENSBORO, NC 27401-1005
(336) 544-5400
Mailing address
2302 FORTUNE LN, GREENSBORO, NC 27408-5412
(336) 254-1233
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5014565
NC
363LG0600X
Gerontology Nurse Practitioner
5014565
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5014565
NORTH CAROLINA BOARD OF NURSING
NC
01
—
AG06210063
AMERICAN ACADEMY OF NURSE PRACTITIONERS
—
Enumeration date
06/21/2021
Last updated
06/21/2021
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