Provider Demographics
NPI:1205200292
Name:FARR, ALISON MAE (RN)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:MAE
Last Name:FARR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:MAE
Other - Last Name:COTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1422 S 116 RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VT
Mailing Address - Zip Code:05443-5104
Mailing Address - Country:US
Mailing Address - Phone:802-881-6078
Mailing Address - Fax:
Practice Address - Street 1:1422 S 116 RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VT
Practice Address - Zip Code:05443-5104
Practice Address - Country:US
Practice Address - Phone:802-881-6078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-14
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0067678163WE0003X
VT101.0118955363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency