Lisa Kay Faulkner

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

350 City View Dr
Suite 302
Evanston, WY 82930-5327

Phone

(307) 789-7915

Fax

(307) 789-6009

NPI assigned

May 4, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1114286580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 CITY VIEW DR",
            "address_2": "SUITE 302",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305327",
            "telephone_number": "307-789-7915",
            "fax_number": "307-789-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 CITY VIEW DR",
            "address_2": "SUITE 302",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305327",
            "telephone_number": "307-789-7915",
            "fax_number": "307-789-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "LISA",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Worker in Evanston, WY
• Providers in Evanston, WY by specialty
• Community Health Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.