Provider Demographics
NPI:1881471571
Name:FARRIS, ASHLEY SARAH (FNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SARAH
Last Name:FARRIS
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 1:912 BRYAN ST
Mailing Address - Street 2:
Mailing Address - City:COTTONPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71327-4288
Mailing Address - Country:US
Mailing Address - Phone:888-995-0591
Mailing Address - Fax:
Practice Address - Street 1:4855 HIGHWAY 10 WEST, SUITE C
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:LA
Practice Address - Zip Code:70638
Practice Address - Country:US
Practice Address - Phone:318-306-6055
Practice Address - Fax:318-306-6054
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA232330363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty