Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | PENDING | IN |
NPI | 1023504354 |
---|---|
Provider Name | Ms. Cassandra Leigh Farmer |
First Address | Indianapolis, IN 46205-1903 |
Second Address | Indianapolis, IN 46268-1915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2018 |
Last Update Date | 10/07/2018 |