Individual
KARYN HARVEY FAREVAAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
353 BLAIR PARK RD, WILLISTON, VT 05495-7530
(802) 847-1470
Mailing address
P.O. BOX 30, GREAT BARRINGTON, MA 01230
(413) 528-9311
(413) 644-0274
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
101-0134554
VT
363L00000X
Nurse Practitioner
265605
MA
363LA2200X
Adult Health Nurse Practitioner
101-0134554
VT
363LA2200X
Adult Health Nurse Practitioner
RN265605
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110098110A
—
MA
Enumeration date
10/10/2013
Last updated
02/11/2021
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