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Individual

JACOB RICHARD FARRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DNAP, CRNA

Contact information

Practice address
10401 W THUNDERBIRD BLVD, SUN CITY, AZ 85351-3004
(630) 240-3186
Mailing address
25111 N 21ST AVE UNIT 142, PHOENIX, AZ 85085-0060
(630) 240-3186

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
251095
AZ

Other

Enumeration date
05/23/2025
Last updated
08/04/2025
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