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Individual
MARYSUE ELIZABETH FARRIS
Active
Individual
MARYSUE ELIZABETH FARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
R0050272
OK
363L00000X
Nurse Practitioner
Primary
50272
OK
363LF0000X
Family Nurse Practitioner
F0816002
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F0816002
AANP CERTIFICATION
OK
01
—
R0050272
RN LICENSE
OK
Enumeration date
04/14/2016
Last updated
05/11/2017
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