Healthcare Provider Details

I. General information

NPI: 1538162409
Provider Name (Legal Business Name): ANN FARRER DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 07/22/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2148 AMI LN
LEXINGTON KY
40516-9602
US

IV. Provider business mailing address

2148 AMI LN
LEXINGTON KY
40516-9602
US

V. Phone/Fax

Practice location:
  • Phone: 859-749-2945
  • Fax: 859-260-1007
Mailing address:
  • Phone: 859-749-2945
  • Fax: 859-260-1007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number208
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: