Individual provider · NPI-1

Michael Anton Facklmann, CRNFA

Registered Nurse, Registered Nurse First Assistant · Charlotte, NC

NPI number1386970515

StatusActive

Last updated in NPPESOct 22, 2009

Details

NPI: 1386970515
Entity type: Individual (NPI-1)
Name: Mr. Michael Anton Facklmann
Credential: CRNFA
Sex: Male
Sole proprietor: No
Enumeration date: Oct 22, 2009
Last updated: Oct 22, 2009

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
163WR0006X	Registered Nurse, Registered Nurse First Assistant	0001206848	VA	Yes

Practice location

1001 Blythe Blvd
Suite 300
Charlotte, NC 28203-5866

Phone 704-373-0212 · Fax 704-373-2626

Mailing address

1001 Blythe Blvd
Suite 300
Charlotte, NC 28203-5866

Phone 704-373-0212 · Fax 704-373-2626

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