Provider Demographics
NPI:1982175261
Name:FARROW, LILLIAN DENISE (CNA)
Entity Type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:DENISE
Last Name:FARROW
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8009 SABRA DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-4833
Mailing Address - Country:US
Mailing Address - Phone:850-288-7965
Mailing Address - Fax:850-607-6806
Practice Address - Street 1:2327 SHOAL CREEK DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5973
Practice Address - Country:US
Practice Address - Phone:850-607-6806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA231349374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide