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General NPI Number Information
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NPI Number | 1699028696
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Entity Type | Individual
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Provider Name | VINCENT BERNARD FARRELL FNP-C
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Gender | Male
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Dates
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Enumeration Date | 10/16/2012
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 5239 HIGHWAY 278 NE
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City | COVINGTON
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State | GA
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Zip | 30014-2671
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Country | US
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Telephone | 678-660-5106
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Fax | 678-660-5107
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Provider Business Mailing Address
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Address Line | 1471 GRANITE SPRINGS DR
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City | CONYERS
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State | GA
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Zip | 30094-5200
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Country | US
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Telephone | 317-607-3987
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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 | APRN-NP244839
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28129625A
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License Number State | IN
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