MEDICARE: SUSAN R FARNSWORTH NP-C

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	363LA2200X	Adult Health Nurse Practitioner	4954023-4405	UT

General Provider Information

NPI Number	:	1184573222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN R FARNSWORTH NP-C

Provider Business Mailing Address
First Line	:	PO BOX 442
Second Line	:
City	:	ENTERPRISE
State	:	UT
Zip	:	84725-0442
Country	:	US
Telephone Number	:	435-251-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1303 N MAIN ST
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84721-9746
Country	:	US
Telephone Number	:	435-868-5690
Fax Number	:

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

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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