Eboni Nicole Fairwell, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

674938 Issued in NY

Practice address

329 Charwood Cir
Rochester, NY 14609-2708

Phone

(585) 465-7387

NPI assigned

Aug 12, 2013

Last updated

May 3, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399075200000",
    "number": "1184057325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 CHARWOOD CIR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146092708",
            "telephone_number": "585-465-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 CHARWOOD CIR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146092708",
            "telephone_number": "585-465-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRWELL",
        "first_name": "EBONI",
        "middle_name": "NICOLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2014-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "674938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• B Caley Fain
• Jason David Fairbourn, MD
• Acadia Reniff Fairchild
• Aubree Megan Fairfull, MD
• Fairport Baptist Home Adhc
• Hafsa Faisal, MD
• Tyeishia Charlene Faison
• Unaiza Faizan, MD
• Mounir Fakhouri, M.D.
• Sharon Lee Falasco, PH.D.

• Registered Nurse in Rochester, NY
• Providers in Rochester, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2014; 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.