Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 13641 | TN |
NPI | 1073518734 |
---|---|
Provider Name | Dr. Marquetta Larneita Faulkner |
First Address | Nashville, TN 37208-3599 |
Second Address | Nashville, TN 37208-3599 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 23/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3049017 | (05) | TN |
E58476 | (02) | TN |