Provider Demographics
NPI:1730297250
Name:FARRAR, SUZANNE E (CRNA)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:E
Last Name:FARRAR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29724 PLATANUS DR
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-5936
Mailing Address - Country:US
Mailing Address - Phone:760-297-1284
Mailing Address - Fax:760-297-1279
Practice Address - Street 1:29724 PLATANUS DR
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-5936
Practice Address - Country:US
Practice Address - Phone:760-297-1284
Practice Address - Fax:760-297-1279
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN490409163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN490409OtherSTATE RN LICENSE NUMBER
CAAANA049186OtherANESTHESIA LICENSE #
CAWNA2382AMedicare ID - Type UnspecifiedMEDICARE ID #