| NPI | 1073840104 |
|---|---|
| Former Name | ANNJANETTE M FAIRCLOTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: TN 18985) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: IN 28198963) |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: IN 71003771) | |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2016-02-03 |