Provider Demographics
NPI:1265229520
Name:FAULKNER, DONNA JEAN (MS, LAC)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:FAULKNER
Suffix:
Gender:
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 MURPHY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1865
Mailing Address - Country:US
Mailing Address - Phone:860-748-5499
Mailing Address - Fax:
Practice Address - Street 1:955 S MAIN ST STE 201B
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-5153
Practice Address - Country:US
Practice Address - Phone:860-748-5499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000890171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist