Healthcare Provider Details

I. General information

NPI: 1174458988
Provider Name (Legal Business Name): ANDI FARRELL B.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11000 UNIVERSITY PKWY
PENSACOLA FL
32514-5732
US

IV. Provider business mailing address

104 ALABAMA AVE
LYNN HAVEN FL
32444-1326
US

V. Phone/Fax

Practice location:
  • Phone: 850-474-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: