Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 42828 | KY |
N | 207V00000X | Obstetrician & Gynecologist | MO2005039869 | MO |
N | 207VG0400X | Gynecologist | MO2005039869 | MO |
N | 207VX0000X | Obstetrician | MO2005039869 | MO |
NPI | 1356372759 |
---|---|
Provider Name | Amy Elizabeth Farrell |
First Address | Philadelphia, PA 19178-0982 |
Second Address | Louisville, KY 40202-1831 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 02/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5909940 | (05) | NC |
7100087230 | (05) | KY |
NOO72D | (05) | SC |