Provider Demographics
NPI:1427581677
Name:FAULK, ELIZABETH (CRNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:FAULK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8607 ASHEWORTH DR UNIT 3
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-8814
Mailing Address - Country:US
Mailing Address - Phone:918-814-7197
Mailing Address - Fax:
Practice Address - Street 1:300 S HULL ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104-6105
Practice Address - Country:US
Practice Address - Phone:334-240-2184
Practice Address - Fax:334-240-2188
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-075182363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner