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Individual

CHARLES B FARMER II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
3939 EASTGATE CT, NORTH FORT MYERS, FL 33917-7236
(239) 543-6099
Mailing address
418 E CHURCH AVE # 55, MEDINA, TN 38355-9762
(731) 267-6861

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
LPN0000040736
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPN0000040736
STATE ISSUED
TN
Enumeration date
06/09/2022
Last updated
06/09/2022
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