Provider Demographics
NPI:1467166983
Name:FAULKNER, MICHAEL TODD JR (FNP)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:TODD
Last Name:FAULKNER
Suffix:JR
Gender:M
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:200 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4358
Mailing Address - Country:US
Mailing Address - Phone:704-874-1904
Mailing Address - Fax:
Practice Address - Street 1:2365 SPRINGS RD NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3067
Practice Address - Country:US
Practice Address - Phone:828-732-5550
Practice Address - Fax:828-732-5551
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5020636363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily