Amanda Lake Faulkner, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

151652 Issued in LA

Practice address

21516 Highway 36
Abita Springs, LA 70420-3906

Phone

(225) 321-2128

NPI assigned

Sep 18, 2018

Last updated

Oct 22, 2024By the provider in NPPES

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

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eating Disorder Treatment Centers, LLC

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• Long Branch Retreat & Recovery Center LLC

  dba Longbranch Recovery Center

  • Substance Abuse Rehabilitation Facility
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  • NPI 1245754894
  NPD

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1215411079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21516 HIGHWAY 36",
            "city": "ABITA SPRINGS",
            "state": "LA",
            "postal_code": "704203906",
            "telephone_number": "225-321-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21516 HIGHWAY 36",
            "city": "ABITA SPRINGS",
            "state": "LA",
            "postal_code": "704203906",
            "telephone_number": "225-321-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "AMANDA",
        "middle_name": "LAKE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "151652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Complete Patient Services LLC
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• Mitchell Cosse
• Vallee Augustus Debellevue II, O.D.
• Beth Ann Evans, D.O.
• Danielle Chiasson Fitzpatrick, RN
• Heather Fontenot
• Hannah Abigail Forrest
• Donna Shartil Golman
• Grand Family Dentistry Abita Springs LLC

• Registered Nurse in Abita Springs, LA
• Providers in Abita Springs, LA by specialty
• Registered Nurse in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.