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General NPI Number Information
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NPI Number | 1598778078
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Entity Type | Organization
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Legal Business Name | STEFAN FARRELL RNFA, PLLC
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 11/27/2012
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Provider Practice Location Address
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Address Line | 1111 E MCDOWELL RD
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City | PHOENIX
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State | AZ
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Zip | 85006-2612
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Country | US
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Telephone | 480-844-9817
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Fax | 480-461-9195
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Provider Business Mailing Address
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Address Line | PO BOX 30361
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City | MESA
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State | AZ
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Zip | 85275-0361
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Country | US
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Telephone | 480-844-9817
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Fax | 480-461-9195
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEFAN BRICE FARRELL
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Credential | CNS, CRNFA
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Telephone | 480-844-9817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP2800X
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Taxonomy Name | Perioperative Clinical Nurse Specialist
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License Number |
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License Number State |
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