Healthcare Provider Details

I. General information

NPI: 1992618623
Provider Name (Legal Business Name): VALERIE ANN FARNSWORTH MHA, BSN, RN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S 3RD ST
EVANSVILLE WI
53536-1289
US

IV. Provider business mailing address

724 ORCHARD VIEW DR
EVANSVILLE WI
53536-8222
US

V. Phone/Fax

Practice location:
  • Phone: 608-882-3161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number150907-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: