Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP141640 | TX |
NPI | 1013588763 |
---|---|
Provider Name | Monica Farris |
First Address | Mission, TX 78572-8636 |
Second Address | Mission, TX 78572-8636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2021 |
Last Update Date | 05/07/2021 |