| Doctor Name: | MRS. EDITH MOODY FAULKNER |
| NPI Number: | 1134460736 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-C |
| License Number: | R865568 |
| Business Practice Address: | 835 Medical Center Dr West Point, MS - 397739320 |
| Business Phone Number: | 6624952300 |
| Business Fax Number: | |
| Mailing Address: | 89 Deer Run, COLUMBUS |
| State: | MS |
| Postal Code: | 397051293 |
| Phone Number: | 6623292293 |
| Fax Number: | |
| NPI Enumeration Date: | 03/06/2013 |
| NPI Last Update Date: | 06/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R865568 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |