Provider Demographics
NPI:1477519387
Name:FARMER, SHEILA
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:
Last Name:FARMER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:BIBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 13888
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24038-3888
Mailing Address - Country:US
Mailing Address - Phone:540-493-4581
Mailing Address - Fax:
Practice Address - Street 1:1900 ELECTRIC RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7474
Practice Address - Country:US
Practice Address - Phone:540-776-4000
Practice Address - Fax:770-237-1727
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167822367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC562014989OtherTRICARE
NC6907604Medicaid
NC6907604Medicaid