Provider Demographics
NPI:1578969044
Name:FARB, ILANA LYNN (DNP, RN)
Entity Type:Individual
Prefix:
First Name:ILANA
Middle Name:LYNN
Last Name:FARB
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Gender:F
Credentials:DNP, RN
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Mailing Address - Street 1:14405 8TH AVE N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-4456
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2603 WHITE BEAR AVE N
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-5110
Practice Address - Country:US
Practice Address - Phone:651-600-3035
Practice Address - Fax:651-348-8783
Is Sole Proprietor?:No
Enumeration Date:2014-11-11
Last Update Date:2017-09-29
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Provider Licenses
StateLicense IDTaxonomies
MNR1578667363LA2200X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health