Russell, Fatia A
Russell, Fatia A is an sole proprietor health care provider with primary practice located at 6245 Lakehaven Dr , Fayetteville NC 28304-0610. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist, which is considered as her primary health care specialty. Russell, Fatia A can be contacted via phone (910) 479-6214.Contact Information
Primary practice address
6245 Lakehaven Dr
Fayetteville NC 28304-0610
Phone: (910) 479-6214
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist | 224P00000X | 108796 | North Carolina |
Profile Details
| NPI number | 1356843379 |
|---|---|
| LBN Legal business name | Russell, Fatia A |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 6th, 2018 |
| Last updated | Aug 31st, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356843379 | NPPES |
| North Carolina | MEDICAID | 108796 |
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