Provider Demographics
NPI:1275903171
Name:FARLETT, AMY KATHERINE (FNPC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:KATHERINE
Last Name:FARLETT
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:KATHERINE
Other - Last Name:COVINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNPC
Mailing Address - Street 1:210 WALMART DR
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-5022
Mailing Address - Country:US
Mailing Address - Phone:423-332-6155
Mailing Address - Fax:423-332-5293
Practice Address - Street 1:210 WALMART DR
Practice Address - Street 2:
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-5022
Practice Address - Country:US
Practice Address - Phone:423-332-6155
Practice Address - Fax:423-332-5293
Is Sole Proprietor?:No
Enumeration Date:2015-10-05
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20512363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily