Shamarra Jackson Farmer, RN

Individual provider Active NPI Ambulatory Care Registered Nurse · Fayetteville, GA

NPI 1710694716 · NPPES record last updated Oct 31, 2022

Key facts

NPI
1710694716
Entity type
Individual (NPI type 1)
Primary specialty
Ambulatory Care Registered Nurse 163WP2201X
License
207756 (GA)
Practice address
133 Windmeadow Way
Fayetteville, GA 30214-5313
Phone
(404) 788-5078
NPI assigned
Oct 31, 2022
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
207756GAMDAmbulatory Care Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 207756 GA Yes

Addresses

Primary practice location

133 Windmeadow Way
Fayetteville, GA 30214-5313

Mailing address

133 Windmeadow Way
Fayetteville, GA 30214-5313
Phone (404) 788-5078

Other providers in Fayetteville, GA

All providers in Fayetteville, GA · Ambulatory Care Registered Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.