Individual
AMANDA O'FARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3174 E RIVER RD, GRAND ISLAND, NY 14072-1982
(716) 471-9402
Mailing address
3174 E RIVER RD, GRAND ISLAND, NY 14072-1982
(716) 471-9402
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
778253
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
778253
REGISTERED PROFESSIONAL NURSE
NY
Enumeration date
09/11/2019
Last updated
09/11/2019
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