Basic Information
| Provider Information | |||||||||
| NPI: | 1558942052 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FARMER | ||||||||
| FirstName: | LAMESHA | ||||||||
| MiddleName: | CAMIELLE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | AGPCNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1122 | ||||||||
| Address2: | |||||||||
| City: | HEPHZIBAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 308151122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7066194866 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 350 AUSTIN GRAYBILL RD | ||||||||
| Address2: | |||||||||
| City: | NORTH AUGUSTA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 298609251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8032784272 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2021 | ||||||||
| LastUpdateDate: | 05/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | RN170971 | GA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LA2200X | 24867 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.