Heather Fairfax, REGISTERED NURSE

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

248827 Issued in NC

Practice address

9040 Jackson Ave
Joint Base Lewis McChord, WA 98431-0001

Phone

(253) 968-3983

NPI assigned

Dec 6, 2022

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

State licenses

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1134830607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRFAX",
        "first_name": "HEATHER",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NC",
            "license": "248827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trent Parker Ellis, DMD
• Arie Emde, DNP, APRN, AGCNS-BC
• Samantha Erdman
• Jacob Matthew Ernst, D.O.
• David Conor Evans, MD
• Thor Farnsworth, M.D.
• Kimberly Ann Fay, RN
• Quantrell L Felder, LPN
• Juan Diego Fernandez, M.D.
• Paola Estefania Fernandez

• Case Management Registered Nurse in Joint Base Lewis McChord, WA
• Providers in Joint Base Lewis McChord, WA by specialty
• Case Management Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.