Provider Demographics
NPI:1336518208
Name:SAINT- LOUIS LUC, FARRAH (FNP)
Entity Type:Individual
Prefix:
First Name:FARRAH
Middle Name:
Last Name:SAINT- LOUIS LUC
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 NW 76TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5143
Mailing Address - Country:US
Mailing Address - Phone:305-794-7139
Mailing Address - Fax:
Practice Address - Street 1:5149 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-4507
Practice Address - Country:US
Practice Address - Phone:954-434-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9304005363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily