Provider Demographics
NPI:1922544170
Name:FARMER PRACTICE LLC
Entity Type:Organization
Organization Name:FARMER PRACTICE LLC
Other - Org Name:FAMILY PRACTICE OF CORRYTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:865-235-4906
Mailing Address - Street 1:7701 CORRYTON RD
Mailing Address - Street 2:
Mailing Address - City:CORRYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37721-2630
Mailing Address - Country:US
Mailing Address - Phone:865-992-3030
Mailing Address - Fax:
Practice Address - Street 1:7701 CORRYTON RD
Practice Address - Street 2:
Practice Address - City:CORRYTON
Practice Address - State:TN
Practice Address - Zip Code:37721-2630
Practice Address - Country:US
Practice Address - Phone:865-992-3030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20294363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1881060168OtherNPPES