Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | SP018045 | PA |
NPI | 1023664067 |
---|---|
Provider Name | Catharine Maria Farnan |
First Address | Havertown, PA 19083-2120 |
Second Address | Philadelphia, PA 19107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2019 |
Last Update Date | 15/08/2019 |