Individual
MRS. CAROL JEANETTE FAIRCHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2020 COMMERCE DR, MELBOURNE, FL 32904-2335
(321) 952-6000
(321) 637-3648
Mailing address
400 EAST SHERIDAN RD, MELBOURNE, FL 32901-3122
(321) 722-5200
(321) 637-3648
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
ARNP2992062
FL
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
ARNP2992062
FL
Other
Enumeration date
04/06/2006
Last updated
02/28/2024
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