| NPI | 1154608719 |
|---|---|
| Former Name | MICHELLE LYNN FARRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 5538) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-132046) |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2015-08-11 |