Individual
PAMELA ANN FARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
401 MATTHEW ST, MARIETTA, OH 45750-1635
(740) 376-1994
(740) 376-1940
Mailing address
PO BOX 449, MARIETTA, OH 45750
(740) 374-4500
(740) 374-5887
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
39190
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.06954-NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2293709
—
OH
05
—
2602574000
—
WV
01
—
P01216336
RAILROAD MEDICARE
OH
Enumeration date
10/04/2005
Last updated
02/01/2022
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