Provider Demographics
NPI:1083683858
Name:FARNELL, JAMES M (CRNA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:FARNELL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1478 SUMMER WOOD LN
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7795
Mailing Address - Country:US
Mailing Address - Phone:330-807-9110
Mailing Address - Fax:
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN534929367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4053AOtherARNP-CRNA
OHRN160236OtherLICENSE NO.
WV63536OtherLICENSE NO.
OHNA-00435OtherCOA-CRNA
KY1101086OtherLICENSE NO.
040338OtherAANA NO.