Individual provider · NPI-1

Travise Farmer

Nurse's Aide · Jonesboro, GA

NPI number1821604869
StatusActive
Last updated in NPPESSep 16, 2020

Details

NPI
1821604869
Entity type
Individual (NPI-1)
Name
Travise Farmer
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 16, 2020
Certification date
Sep 16, 2020
Last updated
Sep 16, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
376K00000X Nurse's Aide––Yes

Practice location

109 Evenview Dr
Jonesboro, GA 30236-4938

Phone 678-886-0754

Mailing address

109 Evenview Dr
Jonesboro, GA 30236-4938

Phone 678-886-0754

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