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Individual

ALEXANDRA CESSNA FARMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
105 S MAJOR ST, EUREKA, IL 61530-1246
(309) 467-4691
Mailing address
105 S MAJOR ST, EUREKA, IL 61530-1246

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085.006132
IL
363AM0700X
Medical Physician Assistant
085006132
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1962941419
IL
Enumeration date
02/16/2017
Last updated
02/23/2018
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