Tracey Ann Farquhar, LPN

Individual provider Active NPI Licensed Practical Nurse · Johnstown, NY

NPI 1295904480 · NPPES record last updated Feb 21, 2008

Key facts

NPI
1295904480
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
210706-1 (NY)
Practice address
20 Gilbert St
Johnstown, NY 12095-2326
Phone
(518) 762-6859
NPI assigned
Feb 21, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
210706-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 210706-1 NY Yes

Addresses

Primary practice location

20 Gilbert St
Johnstown, NY 12095-2326

Mailing address

20 Gilbert St
Johnstown, NY 12095-2326

Other providers in Johnstown, NY

All providers in Johnstown, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.