Provider Demographics
NPI:1558044586
Name:FARHA, NIVEAN J
Entity Type:Individual
Prefix:
First Name:NIVEAN
Middle Name:J
Last Name:FARHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4677 WALNUT CT
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-6106
Mailing Address - Country:US
Mailing Address - Phone:734-678-9198
Mailing Address - Fax:
Practice Address - Street 1:4677 WALNUT CT
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-6106
Practice Address - Country:US
Practice Address - Phone:734-678-9198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty