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NPI Code Detail

MEDICARE: MRS. JOANIE MARIE FARREN LPN

MEDICARE: MRS. JOANIE MARIE FARREN LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NurseIL

General Provider Information

NPI Number : 1003936410
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JOANIE MARIE FARREN LPN
Provider Business Mailing Address
First Line : 210 AVENUE C
Second Line :
City : DANVILLE
State : IL
Zip : 61832-5410
Country : US
Telephone Number : 217-442-3200
Fax Number : 217-442-7460
Provider Business Practice Location Address
First Line : 210 AVENUE C
Second Line :
City : DANVILLE
State : IL
Zip : 61832-5410
Country : US
Telephone Number : 217-442-3200
Fax Number : 217-442-7460
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 07/08/2007

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