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Ms. Mallory Deanne Fairweather, PA-C
Medical Physician Assistant in Fayetteville, North Carolina
NPI 1770224438

Mallory Deanne Fairweather is a Medical Physician Assistant based in Angier, NC and is specialized in Medical. Mallory Deanne Fairweather practices in Fayetteville, NC and has the professional credentials of PA-C. The NPI Number for Mallory Deanne Fairweather is 1770224438 and holds a License No. (North Carolina).

The current practice location address for Mallory Deanne Fairweather is 1638 Owen Dr, Fayetteville, NC and can be reached out via phone at 910-615-4000.

Location: 1638 Owen Dr, Fayetteville, NC, 27501-5914
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770224438
Provider Name
Mallory Deanne Fairweather
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
1638 Owen Dr, Fayetteville, NC, 27501-5914
Phone Number
910-615-4000
Fax Number
Provider Enumeration Date
04/06/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1638 Owen Dr
City
Fayetteville
State
North Carolina
Zip
28304-3424
Phone Number
910-615-4000
Fax Number
person
Provider Business Mailing Address Details
Address
1638 Owen Dr
City
Fayetteville
State
North Carolina
Zip
28304-3424
Phone Number
910-615-4000
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
(North Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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