Healthcare Provider Details

I. General information

NPI: 1013753250
Provider Name (Legal Business Name): SARAH KATHERINE FARR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 16TH AVE
CUMBERLAND WI
54829-8601
US

IV. Provider business mailing address

2352 1ST ST
CUMBERLAND WI
54829-9437
US

V. Phone/Fax

Practice location:
  • Phone: 715-822-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15564-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: