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Individual
SANDRA R FARRELLY
Active
Individual
SANDRA R FARRELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
75437
NC
363LF0000X
Family Nurse Practitioner
Primary
5004023
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7004174
—
NC
05
—
NP1263
—
SC
Enumeration date
05/29/2008
Last updated
09/27/2016
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