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General NPI Number Information
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NPI Number | 1376295196
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Entity Type | Individual
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Provider Name | ANDREA FARRELL NP-C
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Gender | Female
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Dates
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Enumeration Date | 01/23/2022
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 7500 WINDROSE AVE STE B192
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City | PLANO
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State | TX
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Zip | 75024-0163
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Country | US
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Telephone | 469-915-6863
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Fax |
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Provider Business Mailing Address
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Address Line | 604 EVERGREEN RD
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City | AUBREY
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State | TX
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Zip | 76227-4576
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Country | US
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Telephone | 407-314-9172
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1068389
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License Number State | TX
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