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Individual

JOHN FARR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP-BC

Contact information

Practice address
3450 HIGHWAY 80 W, JACKSON, MS 39209-7201
(601) 321-2497
(601) 321-2476
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5815
(601) 984-5842

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
79193
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
901605
MS

Other

Enumeration date
07/11/2016
Last updated
04/28/2020
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