Basic Information
| Provider Information | |||||||||
| NPI: | 1881060168 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FARMER | ||||||||
| FirstName: | FRANKLIN | ||||||||
| MiddleName: | RYAN | ||||||||
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| Credential: | APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7129 ROCKY MOUNTAIN HIGH BLVD | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379180987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8652354906 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3609 OUTDOOR SPORTSMAN PL STE 7 | ||||||||
| Address2: | |||||||||
| City: | KODAK | ||||||||
| State: | TN | ||||||||
| PostalCode: | 377641477 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8652815922 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2015 | ||||||||
| LastUpdateDate: | 05/28/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APN20294 | TN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 20294 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | Q026234 | 05 | TN | MEDICAID | 1881060168 | 01 | TN | UHC COMMUNITY PLAN | OTHER | 1090819 | 01 | TN | CIGNA | OTHER |