Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 000221613 | TN |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 221613 | TN |
NPI | 1295206712 |
---|---|
Provider Name | Daniel Michael Farmer |
First Address | Jefferson City, TN 37760-2112 |
Second Address | Lewes, DE 19958-1462 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2018 |
Last Update Date | 10/12/2018 |