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General NPI Number Information
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NPI Number | 1871175638
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Entity Type | Individual
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Provider Name | ADAM MATTHEW FARNUM NP
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Gender | Male
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Dates
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Enumeration Date | 04/22/2021
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 1003 E MOUNT HOPE AVE
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City | LANSING
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State | MI
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Zip | 48910-1822
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Country | US
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Telephone | 517-853-3704
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Fax | 855-501-6733
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Provider Business Mailing Address
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Address Line | 3955 PATIENT CARE DR STE A
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City | LANSING
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State | MI
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Zip | 48911-4271
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Country | US
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Telephone | 517-374-7600
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Fax | 855-495-5457
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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 | 4704314779
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License Number State | MI
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