Provider Demographics
NPI:1467124412
Name:ROSENTREADER, FARRAH LEE (DNP, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:FARRAH
Middle Name:LEE
Last Name:ROSENTREADER
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79113 N MASON RD
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68855-6159
Mailing Address - Country:US
Mailing Address - Phone:308-440-0207
Mailing Address - Fax:
Practice Address - Street 1:10 E 31ST ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2908
Practice Address - Country:US
Practice Address - Phone:308-865-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE68941163W00000X
NE113849363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse