Healthcare Provider Details

I. General information

NPI: 1851824965
Provider Name (Legal Business Name): CHERRI FARHA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2017
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 N TYLER RD STE 116
WICHITA KS
67212-4916
US

IV. Provider business mailing address

1305 E 19TH AVE
WINFIELD KS
67156-5201
US

V. Phone/Fax

Practice location:
  • Phone: 316-761-4579
  • Fax:
Mailing address:
  • Phone: 620-705-5050
  • Fax: 888-647-6423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5377617061
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number5377617061
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: