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General NPI Number Information
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NPI Number | 1164609368
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Entity Type | Individual
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Provider Name | JOANNA FARRAGHER CNP
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Gender | Female
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5133 RIDGE RD STE 1
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City | WADSWORTH
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State | OH
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Zip | 44281-8078
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Country | US
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Telephone | 330-239-4455
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Fax | 330-239-4456
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Provider Business Mailing Address
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Address Line | 24701 EUCLID AVE THIRD FLOOR BILLING SERVICES
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City | EUCLID
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State | OH
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Zip | 44117-1714
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Country | US
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Telephone | 330-239-4455
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Fax | 330-239-4456
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NP-03259
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License Number State | OH
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