Provider Demographics
NPI:1316244106
Name:FOXX, JUWAIRIYAH KHAFID (FNP)
Entity type:Individual
Prefix:
First Name:JUWAIRIYAH
Middle Name:KHAFID
Last Name:FOXX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-1725
Mailing Address - Fax:704-384-1726
Practice Address - Street 1:16525 HOLLY CREST LN STE 150
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-4911
Practice Address - Country:US
Practice Address - Phone:704-384-8720
Practice Address - Fax:704-384-8747
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006306363LF0000X, 363L00000X
VA0024169221363LF0000X
NC265459363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1316244106Medicaid
NCNCE365BMedicare PIN
NCNCE365DMedicare PIN
NCNCE365CMedicare PIN