# MARYSUE ELIZABETH FARRIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1073967246
- **Gender:** F
- **Credential:** APRN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WA2000X | Administrator Registered Nurse | R0050272 | OK | — |
| 363L00000X | Nurse Practitioner | 50272 | OK | Yes |
| 363LF0000X | Family Nurse Practitioner | F0816002 | OK | — |

## Other

- **Enumeration date:** 04/14/2016
- **Last updated:** 05/11/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | F0816002 | AANP CERTIFICATION | OK |
| 01 | — | R0050272 | RN LICENSE | OK |