Provider Demographics
NPI:1619757812
Name:HONECK, FAITH ALEXANDRIA (PA-C)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:ALEXANDRIA
Last Name:HONECK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:ALEXANDRIA
Other - Last Name:MELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2223 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-4700
Mailing Address - Country:US
Mailing Address - Phone:501-337-9031
Mailing Address - Fax:866-531-8527
Practice Address - Street 1:2223 GRANT ST
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-4700
Practice Address - Country:US
Practice Address - Phone:501-337-9031
Practice Address - Fax:866-531-8527
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical