Healthcare Provider Details

I. General information

NPI: 1912836016
Provider Name (Legal Business Name): COURTNEY FARBER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 ROBIN HOOD LN
FREEDOM NH
03836-4541
US

IV. Provider business mailing address

2500 MYSTIC VALLEY PKWY APT 1106
MEDFORD MA
02155-7110
US

V. Phone/Fax

Practice location:
  • Phone: 603-539-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number114752-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: