Provider Demographics
NPI:1255022315
Name:FARRAR, RHONDA
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:FARRAR
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 1:192 LAKE SHORE RD
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04429-7012
Mailing Address - Country:US
Mailing Address - Phone:207-385-3090
Mailing Address - Fax:207-433-1094
Practice Address - Street 1:192 LAKE SHORE RD
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:ME
Practice Address - Zip Code:04429-7012
Practice Address - Country:US
Practice Address - Phone:207-385-3090
Practice Address - Fax:207-433-1094
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty