Provider Demographics
NPI:1871276972
Name:FARRAR, JENNIFER (CRNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FARRAR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 MEADE ST
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-3169
Mailing Address - Country:US
Mailing Address - Phone:570-342-3675
Mailing Address - Fax:570-342-3316
Practice Address - Street 1:1100 MEADE ST
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-3169
Practice Address - Country:US
Practice Address - Phone:570-342-3675
Practice Address - Fax:570-342-3316
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027993207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine