Provider Demographics
NPI:1205622255
Name:LANKFORD, FAYLENE ROSE (RN)
Entity type:Individual
Prefix:
First Name:FAYLENE
Middle Name:ROSE
Last Name:LANKFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:FAYLENE
Other - Middle Name:ROSE
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:114 WILKESBORO AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-4218
Mailing Address - Country:US
Mailing Address - Phone:336-990-0219
Mailing Address - Fax:
Practice Address - Street 1:114 WILKESBORO AVE
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-4218
Practice Address - Country:US
Practice Address - Phone:336-990-0219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC196590163WP2201X
NC5022257363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care