Lera Dianna Marcelle Farmer, RN,MN,CNNP,CPNP
Individual provider Active NPI Nurse Practitioner · Talladega, AL
NPI 1013136290 · NPPES record last updated Jul 24, 2012
Key facts
- NPI
- 1013136290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 1-036569 (AL)
- Practice address
- 722 Stone Ave
Talladega, AL 35160-2219 - Phone
- (256) 362-1725
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Certified Pediatric Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-036569 | AL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Health Centers, LLC | Past | Accepting new patients | |
| Baptist Health Centers LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1-036569 | AL | Yes |
Addresses
Primary practice location
722 Stone Ave
Talladega, AL 35160-2219
Mailing address
722 Stone Ave
Talladega, AL 35160-2219
Phone (256) 362-1725
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891017656 | Medicaid | AL |
Other providers in Talladega, AL
- Amy Elmore
- Renee Emanuel
- Shania Embry-Caldwell
- Derek English
- Express Pharmacy LLC
- Whitney Faunce
- Eleanor D Fisher
- Kaimana Fisher
- Emily Daffron Fortenberry
- Heather Foster
All providers in Talladega, AL · Nurse Practitioner in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.