Provider Demographics
NPI:1568512531
Name:FAULKNER, LUCINDA CHAPPEL (ARNP)
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:CHAPPEL
Last Name:FAULKNER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4155 BAKER ST NE STE 100
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-1405
Mailing Address - Country:US
Mailing Address - Phone:770-788-0620
Mailing Address - Fax:
Practice Address - Street 1:4155 BAKER ST NE STE 100
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-1405
Practice Address - Country:US
Practice Address - Phone:770-788-0620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3249262363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP66883Medicare UPIN
FLE8025YMedicare ID - Type Unspecified
FLE8025ZMedicare ID - Type Unspecified
FLE8025WMedicare ID - Type Unspecified
FLP66883Medicare UPIN
FLE8052VMedicare ID - Type Unspecified