Individual
ELIZABETH FARAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 S HARRILL AVE, WAGONER, OK 74467-5317
(918) 485-0242
Mailing address
109 S HARRILL AVE, WAGONER, OK 74467-5317
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0071876
OK
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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