Individual
MRS. LAURY FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3030 LAKE AVE STE 24, FORT WAYNE, IN 46805-5428
(260) 705-4587
Mailing address
7160 S STATE ROAD 9, COLUMBIA CITY, IN 46725-9659
(260) 609-4256
(260) 233-7416
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71010496A
IN
363LP2300X
Primary Care Nurse Practitioner
71010496A
IN
Other
Enumeration date
10/22/2020
Last updated
10/30/2025
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