Provider Demographics
NPI:1134638166
Name:FARRELL, NANCY JEAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JEAN
Last Name:FARRELL
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 1:1835 CALVARY RD
Mailing Address - Street 2:
Mailing Address - City:SEAMAN
Mailing Address - State:OH
Mailing Address - Zip Code:45679-9543
Mailing Address - Country:US
Mailing Address - Phone:937-798-5357
Mailing Address - Fax:
Practice Address - Street 1:116 W MULBERRY ST
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693-1300
Practice Address - Country:US
Practice Address - Phone:937-779-3021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-279205163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health