Provider Demographics
NPI:1508127143
Name:FARRELL, PAULETTE MICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:PAULETTE
Middle Name:MICHELLE
Last Name:FARRELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 W 7TH AVE
Mailing Address - Street 2:ROOM 210
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-1100
Mailing Address - Country:US
Mailing Address - Phone:541-682-4236
Mailing Address - Fax:541-682-2455
Practice Address - Street 1:151 W 7TH AVE
Practice Address - Street 2:ROOM 210
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-1100
Practice Address - Country:US
Practice Address - Phone:541-682-4236
Practice Address - Fax:541-682-2455
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200742118RN163WC0400X, 163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn