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General NPI Number Information
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NPI Number | 1114815628
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Entity Type | Individual
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Provider Name | KENZIE SHAY FARRIS MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 901 US HIGHWAY 83 N
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City | CHILDRESS
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State | TX
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Zip | 79201-2320
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Country | US
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Telephone | 940-937-6371
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Fax |
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Provider Business Mailing Address
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Address Line | 802 AVENUE C NW
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City | CHILDRESS
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State | TX
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Zip | 79201-4318
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Country | US
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Telephone | 940-585-8656
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1205035
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License Number State | TX
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