Provider Demographics
NPI:1043916075
Name:FARR, CHELSEA REBECCA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:REBECCA
Last Name:FARR
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7133 COLUMBIA HWY
Mailing Address - Street 2:
Mailing Address - City:EATON RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:48827-9348
Mailing Address - Country:US
Mailing Address - Phone:517-896-6329
Mailing Address - Fax:
Practice Address - Street 1:1120 E MICHIGAN AVE STE A
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1810
Practice Address - Country:US
Practice Address - Phone:517-364-9790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704318290363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner