Provider Demographics
NPI:1548979701
Name:FAULKENBURY, CARLY WALKER (NP)
Entity type:Individual
Prefix:DR
First Name:CARLY
Middle Name:WALKER
Last Name:FAULKENBURY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 GRAND HILL PL
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-4483
Mailing Address - Country:US
Mailing Address - Phone:919-295-9483
Mailing Address - Fax:
Practice Address - Street 1:123 SHADOW RIDGE DR
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-8432
Practice Address - Country:US
Practice Address - Phone:919-630-6249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFAULK-AE38Y207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine