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Individual

EBONI FARMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
104 POMONA DR, GREENSBORO, NC 27407-1616
(336) 268-4100
(336) 268-3158
Mailing address
625 MIZPAH CHURCH RD, REIDSVILLE, NC 27320-1518
(336) 432-9186

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5015663
NC
363LF0000X
Family Nurse Practitioner
Primary
5015663
NC

Other

Enumeration date
01/25/2022
Last updated
12/27/2024
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