MEDICARE: REBECCA OLIVIA FARRELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	5023320	NC

General Provider Information

NPI Number	:	1720950348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA OLIVIA FARRELL

Provider Business Mailing Address
First Line	:	616 CORMICHE LN
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-3386
Country	:	US
Telephone Number	:	561-779-9268
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 DUKE MEDICINE CIR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27710-4000
Country	:	US
Telephone Number	:	919-668-8385
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	03/25/2026

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