Mrs Jordan Michalea Farewell, | |
7910 Us Hwy 117 S Unit 120, Rocky Point, NC 28457-7409 | |
(910) 300-4500 | |
(910) 550-3787 |
Full Name | Mrs Jordan Michalea Farewell |
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Gender | Female |
Speciality | Nurse Practitioner |
Location | 7910 Us Hwy 117 S Unit 120, Rocky Point, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255117719 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 5018925 (North Carolina) | Primary |
363LP2300X | Nurse Practitioner - Primary Care | FARE-3C9AF (North Carolina) | Secondary |
Entity Name | Novant Health Medical Group Coastal Region Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649865791 PECOS PAC ID: 2860809936 Enrollment ID: O20210408000285 |
Mailing Address | Practice Location Address |
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Mrs Jordan Michalea Farewell, Po Box 936857, Atlanta, GA 31193-6857 Ph: (910) 300-4500 | Mrs Jordan Michalea Farewell, 7910 Us Hwy 117 S Unit 120, Rocky Point, NC 28457-7409 Ph: (910) 300-4500 |
Matthew Bryan Spudy, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7910 Us Hwy 117 S Unit 120, Rocky Point, NC 28457 Phone: 910-300-4500 Fax: 910-550-3787 | |
Mrs. Amber Annab Gordon, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 106 Teel Ct, Rocky Point, NC 28457 Phone: 919-270-0957 |