MEDICARE: CATHERINE FARRELL

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
1	374T00000X	Religious Nonmedical Nursing Personnel

General Provider Information

NPI Number	:	1053781294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE FARRELL

Provider Business Mailing Address
First Line	:	12630 ROTT RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1214
Country	:	US
Telephone Number	:	314-965-3833
Fax Number	:

Provider Business Practice Location Address
First Line	:	12630 ROTT RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1214
Country	:	US
Telephone Number	:	314-965-3833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2015
Last Update Date	:	09/30/2015

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Directions to “ CATHERINE FARRELL ” Practice Location

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