Basic Information
Provider Information
NPI: 1275878001
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FARNHAM
FirstName: GENEVIEVE
MiddleName: KERR
NamePrefix: MS.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4645 NW 8TH AVE
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326054524
CountryCode: US
TelephoneNumber: 3522642500
FaxNumber: 3523319095
Practice Location
Address1: 4645 NW 8TH AVE
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326054524
CountryCode: US
TelephoneNumber: 3522642500
FaxNumber: 3523319095
Other Information
ProviderEnumerationDate: 12/05/2012
LastUpdateDate: 05/27/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100XARNP9352142FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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