Provider Demographics
NPI:1932196409
Name:FAULKNER, NOREEN C (MD)
Entity Type:Individual
Prefix:
First Name:NOREEN
Middle Name:C
Last Name:FAULKNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NOREEN
Other - Middle Name:C
Other - Last Name:BUITING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1419 W BELLA DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-5250
Mailing Address - Country:US
Mailing Address - Phone:765-660-7580
Mailing Address - Fax:
Practice Address - Street 1:1419 W BELLA DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-5250
Practice Address - Country:US
Practice Address - Phone:765-660-7580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027783207V00000X
IN01068603207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000672807OtherBCBS
IN200993280Medicaid
WA8141277Medicaid
WA113642OtherL & I
WA160058993OtherRR MEDICARE
WAAB00400Medicare ID - Type Unspecified
WA8141277Medicaid
WA160058993OtherRR MEDICARE