Provider Demographics
NPI:1043899743
Name:TROTTIER, FARRAH ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:FARRAH
Middle Name:ANN
Last Name:TROTTIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 WALNUT ST E
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-3111
Mailing Address - Country:US
Mailing Address - Phone:701-230-2525
Mailing Address - Fax:
Practice Address - Street 1:716 WALNUT ST E
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-3111
Practice Address - Country:US
Practice Address - Phone:701-230-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR344823747P1801X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant