Provider Demographics
NPI:1285412601
Name:FARRAR, ANDREA RAE (RN)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:RAE
Last Name:FARRAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:RAE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 N TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77803-5317
Mailing Address - Country:US
Mailing Address - Phone:979-361-5721
Mailing Address - Fax:979-823-2275
Practice Address - Street 1:201 N TEXAS AVE
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77803-5317
Practice Address - Country:US
Practice Address - Phone:979-361-5721
Practice Address - Fax:979-823-2275
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1039491163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health