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NPI Code Detail

MEDICARE: KIA LYNN FARRELL LVN

MEDICARE: KIA LYNN FARRELL LVN
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
1164X00000XLicensed Vocational Nurse727847CA
2164W00000XLicensed Practical Nurse190915OH

General Provider Information

NPI Number : 1235092917
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIA LYNN FARRELL LVN
Provider Business Mailing Address
First Line : PO BOX 751
Second Line :
City : FOREST RANCH
State : CA
Zip : 95942-0751
Country : US
Telephone Number : 530-828-7400
Fax Number :
Provider Business Practice Location Address
First Line : 7400 HUNTINGTON PARK DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43235-5617
Country : US
Telephone Number : 614-505-0377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/10/2025

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