Provider Demographics
NPI:1447808605
Name:FARRELL, MAUREEN CATHERINE (MIDWIFE)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:CATHERINE
Last Name:FARRELL
Suffix:
Gender:F
Credentials:MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 296
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:WV
Mailing Address - Zip Code:26253-0296
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1474 KNAPP HOLLOW ROAD
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:WV
Practice Address - Zip Code:26253
Practice Address - Country:US
Practice Address - Phone:304-339-4731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife