Fawkes, Tera Marie
Fawkes, Tera Marie is an individual health care provider with primary practice located at 488 Bing St , Grand Junction CO 81504-6113. She recently has only one registered license in Other Service Providers / Driver, which is considered as her primary health care specialty. Fawkes, Tera Marie can be contacted via phone (970) 589-0027.Contact Information
Primary practice address
488 Bing St
Grand Junction CO 81504-6113
Phone: (970) 589-0027
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Driver | 172A00000X | B4404799 | California |
Profile Details
| NPI number | 1538875505 |
|---|---|
| LBN Legal business name | Fawkes, Tera Marie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2023 |
| Last updated | Jan 24th, 2023 - about 3 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 | 1538875505 | NPPES |
| Colorado | MEDICAID | P586842 |
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