Provider Demographics
NPI:1255191383
Name:FARMER, SCHANEL
Entity type:Individual
Prefix:
First Name:SCHANEL
Middle Name:
Last Name:FARMER
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 1:281 WESTBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-1543
Mailing Address - Country:US
Mailing Address - Phone:121-638-5735
Mailing Address - Fax:
Practice Address - Street 1:281 WESTBRIDGE DR
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-1543
Practice Address - Country:US
Practice Address - Phone:121-638-5735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker