Provider Demographics
NPI:1881843100
Name:FARTHING, SARAH KATHRYN I (NP-C)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:KATHRYN
Last Name:FARTHING
Suffix:I
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19584 PARKVIEW LANE
Mailing Address - Street 2:19548 PARKVIEW LANE
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-1139
Mailing Address - Country:US
Mailing Address - Phone:612-377-5455
Mailing Address - Fax:612-863-6899
Practice Address - Street 1:19584 PARKVIEW LANE
Practice Address - Street 2:19548 PARKVIEW LANE
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-1139
Practice Address - Country:US
Practice Address - Phone:612-377-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR095591-9363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNG01619Medicare UPIN