Provider Demographics
NPI:1871872804
Name:FARRELL, LISA MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:FARRELL
Suffix:
Gender:F
Credentials:ARNP
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 26846
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66225-6846
Mailing Address - Country:US
Mailing Address - Phone:316-312-7780
Mailing Address - Fax:316-295-3732
Practice Address - Street 1:1541 N LINDBERG CIR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-6400
Practice Address - Country:US
Practice Address - Phone:316-312-7780
Practice Address - Fax:316-295-3732
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS143315363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily