Provider Demographics
NPI:1730791641
Name:FARMER, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:FARMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 E WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-2138
Mailing Address - Country:US
Mailing Address - Phone:470-535-5907
Mailing Address - Fax:
Practice Address - Street 1:150 WHITES BOTTOM RD
Practice Address - Street 2:
Practice Address - City:PENDERGRASS
Practice Address - State:GA
Practice Address - Zip Code:30567-2814
Practice Address - Country:US
Practice Address - Phone:470-535-5907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide