Provider Demographics
NPI:1356174270
Name:FARRIS, ZABRENA
Entity type:Individual
Prefix:
First Name:ZABRENA
Middle Name:
Last Name:FARRIS
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 1:4945 ANTELOPE DR
Mailing Address - Street 2:
Mailing Address - City:BAR NUNN
Mailing Address - State:WY
Mailing Address - Zip Code:82601-9488
Mailing Address - Country:US
Mailing Address - Phone:307-251-8444
Mailing Address - Fax:
Practice Address - Street 1:4945 ANTELOPE DR
Practice Address - Street 2:
Practice Address - City:BAR NUNN
Practice Address - State:WY
Practice Address - Zip Code:82601-9488
Practice Address - Country:US
Practice Address - Phone:307-251-8444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator