Provider Demographics
NPI:1164609368
Name:FARRAGHER, JOANNA (CNP)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:
Last Name:FARRAGHER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:330-239-4455
Mailing Address - Fax:330-239-4456
Practice Address - Street 1:5133 RIDGE RD STE 1
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-8078
Practice Address - Country:US
Practice Address - Phone:330-239-4455
Practice Address - Fax:330-239-4456
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-03259363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3077727Medicaid
OH3077727Medicaid