Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 000427 | CT |
N | 363LW0102X | Nurse Practitioner - Women's Health | 000427 | CT |
NPI | 1023226305 |
---|---|
Provider Name | Ms. Eileen Callahan Farrar |
First Address | Hartford, CT 06112-1548 |
Second Address | Hartford, CT 06112-1548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 04/06/2013 |