Provider Demographics
NPI:1356094130
Name:FAULKNER, TABREEKA M (RN)
Entity Type:Individual
Prefix:
First Name:TABREEKA
Middle Name:M
Last Name:FAULKNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7583 CHANCEY LN
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-1449
Mailing Address - Country:US
Mailing Address - Phone:678-596-0137
Mailing Address - Fax:
Practice Address - Street 1:7583 CHANCEY LN
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30296-1449
Practice Address - Country:US
Practice Address - Phone:678-596-0137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN226990163WC1500X, 163WC2100X, 163WD0400X, 163WE0900X, 163WH0200X, 163WI0500X, 163WI0600X, 163WN1003X, 163WP0000X, 163WW0000X, 163WX0800X, 163WX1500X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care