Provider Demographics
NPI:1912753450
Name:FARLER, MICHELLE LYNETTE
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LYNETTE
Last Name:FARLER
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 1:722 S CLAY ST
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-2077
Mailing Address - Country:US
Mailing Address - Phone:419-231-0069
Mailing Address - Fax:
Practice Address - Street 1:722 S CLAY ST
Practice Address - Street 2:
Practice Address - City:DELPHOS
Practice Address - State:OH
Practice Address - Zip Code:45833-2077
Practice Address - Country:US
Practice Address - Phone:419-231-0069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker