Provider Demographics
NPI:1528377140
Name:FARRELL, LAURIE A (CRNP)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:FARRELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:705 WHITE HORSE RD SUITE D-105
Mailing Address - Street 2:COMPREHENSIVE CANCER & HEMATOLOGY SPECIALISTS, P.C.
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2468
Mailing Address - Country:US
Mailing Address - Phone:856-435-1777
Mailing Address - Fax:856-435-7291
Practice Address - Street 1:705 WHITE HORSE RD SUITE D-105
Practice Address - Street 2:COMPREHENSIVE CANCER & HEMATOLOGY SPECIALISTS, P.C.
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2468
Practice Address - Country:US
Practice Address - Phone:856-435-1777
Practice Address - Fax:856-435-7291
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00305400363LF0000X
PASP011531363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily