Healthcare Provider Details

I. General information

NPI: 1750682019
Provider Name (Legal Business Name): JULIE LYNN FARRIER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2010
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 S BANEY RD STE 300
ASHLAND OH
44805-4502
US

IV. Provider business mailing address

1941 S BANEY RD STE 300
ASHLAND OH
44805-4502
US

V. Phone/Fax

Practice location:
  • Phone: 419-207-2663
  • Fax: 419-289-4631
Mailing address:
  • Phone: 419-207-2663
  • Fax: 419-289-4631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50-003157
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: