Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 95001408 | CA |
NPI | 1619373404 |
---|---|
Provider Name | Lucy Michelle Farris |
First Address | Parlier, CA 93648-2666 |
Second Address | Parlier, CA 93648-2666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2014 |
Last Update Date | 06/11/2014 |