Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 2014-01015 | NC |
Y | 207VX0201X | Gynecologic Oncologist | 2014-01015 | NC |
N | 207VX0201X | Gynecologic Oncologist | 29244 | AL |
NPI | 1144423542 |
---|---|
Provider Name | Janelle Marie Fauci |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28204-3215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 13/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01905778 | (05) | MS |
051116590 | BCBS (01) | AL |
051116591 | BCBS (01) | AL |
051116592 | BCBS (01) | AL |
051116593 | BCBS (01) | AL |
051116594 | BCBS (01) | AL |
051116595 | BCBS (01) | AL |
051116596 | BCBS (01) | AL |
1144423542 | (05) | NC |
128468 | (05) | AL |
128470 | (05) | AL |
128471 | (05) | AL |
128472 | (05) | AL |
128473 | (05) | AL |
128474 | (05) | AL |
128475 | (05) | AL |