Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | F09180009 | FL |
N | 363L00000X | Nurse Practitioner | F09180009 | NC |
N | 363LA2200X | Nurse Practitioner - Adult Health | F09180009 | FL |
N | 363LA2200X | Nurse Practitioner - Adult Health | F09180009 | NC |
N | 363LC1500X | Nurse Practitioner - Community Health | F09180009 | FL |
N | 363LC1500X | Nurse Practitioner - Community Health | F09180009 | NC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | F09180009 | FL |
N | 363LP0200X | Nurse Practitioner - Pediatrics | F09180009 | FL |
N | 363LP0200X | Nurse Practitioner - Pediatrics | F09180009 | NC |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F09180009 | FL |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F09180009 | NC |
NPI | 1609344977 |
---|---|
Provider Name | Mrs. Farah Edwidge Johanne Sajous |
First Address | Greensboro, NC 27403-3135 |
Second Address | Lake Worth, FL 33467 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2018 |
Last Update Date | 02/11/2021 |