Individual
MARJORIE E FARABEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
4331 S FREMONT AVE, SPRINGFIELD, MO 65804-7328
(417) 820-5000
(417) 820-5025
Mailing address
4331 S FREMONT AVE, SPRINGFIELD, MO 65804-7328
(417) 820-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
072392
MO
363LP0200X
Pediatric Nurse Practitioner
Primary
072392
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108136
MO BLUE SHIELD
MO
05
—
423771302
—
MO
Enumeration date
02/08/2007
Last updated
07/02/2019
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