Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 078182-23 | NH |
N | 363LG0600X | Nurse Practitioner - Gerontology | 078182-23 | NH |
NPI | 1003482530 |
---|---|
Provider Name | Katherine Jo Farrell |
First Address | Nashua, NH 03061-3677 |
Second Address | Nashua, NH 03060-3925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2021 |
Last Update Date | 04/08/2021 |