Provider Demographics
NPI:1275759292
Name:LAMBERSON, FAITH NICOLE (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:FAITH
Middle Name:NICOLE
Last Name:LAMBERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4815 OLEANDER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-5108
Mailing Address - Country:US
Mailing Address - Phone:910-452-5797
Mailing Address - Fax:910-452-5897
Practice Address - Street 1:4815 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5108
Practice Address - Country:US
Practice Address - Phone:910-452-5797
Practice Address - Fax:910-452-5897
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001957363A00000X
NC0010-02315363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant